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BACKGROUND: An estimated 86 million Americans aged ≥20 years have prediabetes, and approximately 15%–30% progress to type 2 diabetes within 5 years. We assessed magnitude of prediabetes and risk factors among Alabama adults as a critical step toward development of strategies to prevent progression to diabetes.
METHODS: Using 2013 Behavioral Risk Factor Surveillance System (BRFSS) data, we described prediabetes prevalence and risk factors in Alabama. BRFSS, a state-based representative phone survey, includes health and risk factor data on adults aged ≥18 years. Respondents (n=6,503) self-reported height, weight, exercise habits, income, and whether they had ever been told they had prediabetes or borderline diabetes unrelated to pregnancy. Weighted analyses were conducted to describe state estimates of diagnosed prediabetes prevalence, body mass index (BMI), and physical activity.
RESULTS: Approximately 255,000 Alabama adults aged ≥18 years (8.5%, 95% confidence interval [CI]: 7.5%—9.6%) reported being told they have prediabetes. Over 40% of persons reporting prediabetes had an annual household income <$25,000, approximately 83% were overweight or obese (BMI ≥25), and only 9.8% described both aerobic exercise and strength training habits that met recommended guidelines for physical activity. In a logistic model controlling for age and sex, adjusted odds of prediabetes was 2.4 times greater for adults with BMI ≥25 than those with BMI <25. Adjusted odds of prediabetes was 1.5 times higher among those not meeting physical activity guidelines compared with those who met recommended guidelines.
CONCLUSIONS: A substantial proportion of Alabama residents with prediabetes had low income, were overweight or obese, and did not meet recommended physical activity guidelines. Being overweight or obese and failure to meet physical activity guidelines approximately doubled odds of prediabetes. The findings and conclusions in this abstract are those of the authors and do not necessarily reflect the official position of the Centers for Disease Control and Prevention.