Skip directly to searchSkip directly to the site navigationSkip directly to the page's main content
Skip directly to searchSkip directly to the site navigationSkip directly to this page's context menuSkip directly to the page's main content
State of Alaska

Health Indicator Report of Diabetes: Prediabetes Prevalence

Prediabetes is a condition in which individuals have blood glucose or A1c levels higher than normal, but not high enough to be classified as diabetes. Prediabetes is also referred to as Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG) - because it is a state of elevated blood glucose levels. Prediabetes affects a large portion of Alaskans. More than one out of every three U.S. adults has prediabetes, and Alaska is likely to have similar prevalence. Unfortunately, 9 out of every 10 people with prediabetes do not know they have this condition.^1^ Without weight loss and moderate physical activity, many people with prediabetes will develop type 2 diabetes within 5 years.^2^ Prediabetes and type 2 diabetes result in higher risk of developing adverse health outcomes including, but not limited to: an increased risk of heart disease, stroke, neuropathy, kidney damage, eye damage, foot damage leading to amputations, hearing impairment, skin conditions, and in some cases Alzheimer's disease.^3-5^ These adverse health outcomes can largely be avoided through lifestyle changes and medication management. Before developing type 2 diabetes, people almost always have prediabetes. A person will not develop type 2 diabetes automatically after having prediabetes. Early intervention for some people with prediabetes can help them return to normal blood glucose ranges.^6^ Research has shown that people with prediabetes can reduce their risk for developing type 2 diabetes by 58% or more by losing 5%-7% of body weight and exercising moderately for 150 minutes per week through a structured lifestyle change program.^7^, ^8^ In addition to the adverse health outcomes, another negative consequence of type 2 diabetes is financial cost. According to An economic analysis of Alaska Medicaid claims it was estimated that diabetes cost the Alaska Medicaid program about $166 million in 2014; this was approximately $26,310 per beneficiary with diabetes in a single year.^9^ [[br]] [[br]] ---- {{class .SmallerFont See "'Resources and References"' tab for references. }}

Notes

Prevalence rates are exclusive of individuals with diagnosed diabetes. Prediabetes can include women who respond "Yes, during pregnancy" when asked about pre-diabetes or borderline diabetes.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion

Data Interpretation Issues

The Behavioral Risk Factor Surveillance System (BRFSS) is the primary source for estimating prediabetes prevalence for Alaska. The median of states, District of Columbia, and territories provide a comparison for the United States (U.S.). The BRFSS is a telephone survey of adults 18 and over. Information on background and methodology of the BRFSS managed by the Centers for Disease Control and Prevention (CDC) can be found at: [http://www.cdc.gov/brfss/]. The website for the Alaska BRFSS is: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx]. Alaska data on prediabetes were obtained from the combined Standard and Supplemental Alaska BRFSS surveys from 2008 onward. Alaska Native people in analyses of the BRFSS refers to any mention of American Indian or Alaska Native heritage when enumerating racial and ethnic background. Individuals who indicate multiple races including American Indian/Alaska Native are considered Alaska Native in the data. When race and ethnicity are consider concurrently, Hispanic individuals with American Indian/Alaska Native heritage are combined into the Alaska Native (any mention) group and removed from the Hispanic class. This definition of the Alaska Native group is intended to conform to the eligibility requirements for access to Alaska Native Tribal Health Consortium health care services.

Definition

Percentage of adults 18 years of age and older who responded either "No, prediabetes or borderline diabetes" to the question: "Has a doctor, nurse, or other health professional ever told you have diabetes?" or, if the response was "No", then the respondent answered "Yes" or "Yes, during pregnancy" to the follow-up question: "Have you ever been told by a doctor or other health professional that you have pre-diabetes or borderline diabetes?" on the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)].

Numerator

Weighted number of adults (18+) who responded either "No, prediabetes or borderline diabetes" to the question: "Has a doctor, nurse, or other health professional ever told you have diabetes?" or, if the response was "No", then the respondent answered "Yes" or "Yes, during pregnancy" to the follow-up question: "Have you ever been told by a doctor or other health professional that you have pre-diabetes or borderline diabetes?" on the BRFSS.

Denominator

Weighted number of adults (18+) with complete and valid responses on the BRFSS to the diabetes and the prediabetes questions, excluding those with missing, "Don't know/Not sure", or "Refused" responses.

Healthy People Objective: Increase the proportion of persons at high risk for diabetes with pre-diabetes who report increasing their levels of physical activity

U.S. Target: 49.1 percent

How Are We Doing?

In 2016, the self-reported prevalence of prediabetes was higher in females (13.6%) compared to males (8.7%). Those less than 45 years of age have significantly lower prevalence of prediabetes than those 45 years of age and older. Prediabetes prevalence rates from the BRFSS are initially presented for all Alaskans and Alaska Native people for all available years from 2008-2016. Subsequent analyses are by demographic subpopulations (e.g. sex, age, race/ethnicity, ethnicity, marital status, education, employment status, income, and poverty status). Cross-tabulations were also conducted for three-year averages by body mass index, current smoking, sexual orientation, disability, and number of adverse childhood experiences (ACEs). Only the significant differences evident in contrasts by body mass index, disability, and ACEs are presented but the other results are available upon request. Prediabetes prevalence by regions of Alaska are presented for the most recent time period allowing reporting for all Alaskans and Alaska Native people: 1) single-year for the 6 Alaska Public Health Regions, 2) three-year averages by the 7 Metropolitan and Micropolitan Statistics Areas and rural remainder, 3) single-year for the 10 behavioral health assessment regions based upon aggregations of 20,000 population, 4) three-year averages for 29 boroughs and census areas, and 5) five-year averages for the 12 tribal health organization regions. These time intervals match those for the InstantAtlas health profiles for each of the geographic regionalizes of Alaska for those desiring longer time series.

What Is Being Done?

Public health partners around the state are using evidence-based practices to increase awareness of prediabetes, increase screenings and provide access to diabetes prevention programs leading to increased physical activity as well as other lifestyle changes. Some examples of evidence-based practices used are listed below.

Evidence-based Practices

'''Strategy 1:''' [[br]]Increase the number of people who are aware that they are at risk of developing type 2 diabetes.^10^ The Alaska Diabetes Prevention and Control Program (DPCP) works to increase public awareness of the warning signs, symptoms, and risk factors for developing diabetes. DPCP seeks innovative ways to encourage people at risk to recognize that they may be at risk for prediabetes and need to be tested. Increasing the individual's knowledge of prediabetes is the first step. '''Strategy 2:''' [[br]]Increase participation in an evidence-based diabetes prevention program to prevent, decrease, and delay the negative health consequences that are associated with prediabetes.^10^ Specifically, DPCP promotes the Diabetes Prevention Program (DPP). DPP is an evidence-based lifestyle change program for preventing type 2 diabetes.^10^ DPP is a year-long program, typically in a group format led by a lifestyle coach specially trained to lead the program. The program consists of 16 weekly sessions during the first six months, followed by monthly sessions during the second six months. Individuals learn the skills necessary to change behavior and follow a healthier lifestyle, including healthy eating, physical activity, stress reduction, problem-solving, and other life skills for living a longer and healthier life. The DPP has been able to help individuals lose 5% to 7% of their body weight and cut the risk of developing type 2 diabetes by 58% or more.^7,10-12^ You can learn more about this program at the National Diabetes Information Clearing House [http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram/]. To learn more about this program and others go to [http://www.alaska.diabetes.gov]. [[br]] [[br]] ---- {{class .SmallerFont See "'Resources and References"' tab for references. }}

Available Services

Alaska Diabetes Prevention Program (DPP) locations: Anchorage: YMCA DPP [http://www.ymca.net/y-profile/?assn=0153&address=99507] Fairbanks: UAF Cooperative Extension Service, contact Leslie Shallcross at 907-474-2426; lashallcross@alaska.edu Juneau: Bartlett Regional Hospital [https://www.bartletthospital.org/services/diabetes-education.aspx] Ketchikan: Ketchikan Indian Community Prediabetes Prevention Program [http://kictribe.org/healthcare/wellness/index.html] Statewide: UAF Cooperative Extension Service [http://www.uaf.edu/ces/districts/anchorage/hhfd/]
Page Content Updated On 08/18/2017, Published on 09/21/2017
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sat, 22 September 2018 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Thu, 21 Sep 2017 10:20:50 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sat, 22 September 2018 3:04:30 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Thu, 21 Sep 2017 10:20:50 AKDT