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BACKGROUND: Individuals with prediabetes have increased risk of developing type 2 diabetes. In 2011, 6.3% of Maine adults reported ever being diagnosed with prediabetes (prediabetes awareness); this probably underestimates prediabetes awareness among high-risk groups for diabetes, who are at greatest need for intervention. According to the CDC, diabetes risk factors include being aged ≥ 45 years, overweight, or physically inactive. This study examined the prevalence of high-risk groups for diabetes among Maine adults and the prevalence of prediabetes awareness and diabetes testing among high-risk groups.
METHODS: We analyzed data on prediabetes awareness and diabetes testing among 13,423 Maine adults aged ≥ 18 years from the 2011 Behavioral Risk Factor Surveillance System; all data are self-reported. High-risk groups were defined using diabetes risk factors based on CDC recommendations. We examined differences in prediabetes awareness and diabetes testing by demographic factors, and mental health status (history of diagnosed depression or anxiety). We used logistic regression to examine factors associated with prediabetes awareness and diabetes testing among high-risk groups using SAS 9.3 survey procedures. All data were weighted to the Maine adult population.
RESULTS: Maine adults who were overweight or obese were the largest high-risk group (62.2%, 95% confidence interval [CI]: 61.0–63.3). Maine adults with high cholesterol and overweight or obese adults with a diagnosis of cardiovascular disease (CVD) were most likely to report prediabetes awareness compared to adults without high cholesterol and normal weight adults. After adjusting for education, annual household income, and mental health status, prediabetes awareness was significantly associated with having high cholesterol (odds ratio [OR] =2.8, CI: 1.9–4.1), being overweight or obese (OR=2.6, CI: 1.6–4.3), and having any CVD diagnosis (OR=3.8, CI: 2.3–6.2). Sixty percent of Maine adults reported being tested for diabetes in the past three years; diabetes testing was lowest among overweight or obese adults without a CVD diagnosis (47.0%, CI: 42.1–52.0) and physically inactive adults (42.7%, CI: 38.6–46.9), especially among adults aged 18–44 years.
CONCLUSIONS: A large proportion of Maine adults were overweight or obese, but having a CVD diagnosis is a stronger factor than obesity for prediabetes awareness across age groups. Diabetes testing was low among overweight or obese adults without diagnosed CVD. Increased prediabetes awareness and testing efforts in Maine should be aimed to overweight or obese adults, particularly young adults, even in the absence of CVD, for early intervention.