Trends in diabetes incidence among 7 million insured adults, 2006-2011: the SUPREME-DM project

An observational cohort analysis was conducted within the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) DataLink, a consortium of 11 integrated health-care delivery systems with electronic health records in 10 US states. Among nearly 7 million adults aged 20 years or old...

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Bibliographic Details
Published in:American journal of epidemiology 2015-01, Vol.181 (1), p.32-39
Main Authors: Nichols, Gregory A, Schroeder, Emily B, Karter, Andrew J, Gregg, Edward W, Desai, Jay, Lawrence, Jean M, O'Connor, Patrick J, Xu, Stanley, Newton, Katherine M, Raebel, Marsha A, Pathak, Ram D, Waitzfelder, Beth, Segal, Jodi, Lafata, Jennifer Elston, Butler, Melissa G, Kirchner, H Lester, Thomas, Abraham, Steiner, John F
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Blood Chemical Analysis - trends
Blood Glucose - analysis
Body mass index
Diabetes
Diabetes Mellitus - diagnosis
Diabetes Mellitus - epidemiology
Diabetes Mellitus - ethnology
Ethnicity
Female
Glycated Hemoglobin A - analysis
Hemoglobin
Humans
Incidence
Male
Middle Aged
Original Contributions
Surveillance
United States - epidemiology
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Summary:An observational cohort analysis was conducted within the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) DataLink, a consortium of 11 integrated health-care delivery systems with electronic health records in 10 US states. Among nearly 7 million adults aged 20 years or older, we estimated annual diabetes incidence per 1,000 persons overall and by age, sex, race/ethnicity, and body mass index. We identified 289,050 incident cases of diabetes. Age- and sex-adjusted population incidence was stable between 2006 and 2010, ranging from 10.3 per 1,000 adults (95% confidence interval (CI): 9.8, 10.7) to 11.3 per 1,000 adults (95% CI: 11.0, 11.7). Adjusted incidence was significantly higher in 2011 (11.5, 95% CI: 10.9, 12.0) than in the 2 years with the lowest incidence. A similar pattern was observed in most prespecified subgroups, but only the differences for persons who were not white were significant. In 2006, 56% of incident cases had a glycated hemoglobin (hemoglobin A1c) test as one of the pair of events identifying diabetes. By 2011, that number was 74%. In conclusion, overall diabetes incidence in this population did not significantly increase between 2006 and 2010, but increases in hemoglobin A1c testing may have contributed to rising diabetes incidence among nonwhites in 2011.
ISSN:0002-9262
1476-6256
DOI:10.1093/aje/kwu255