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BACKGROUND: Prediabetes is a condition defined by a blood glucose level higher than normal (A1C 5.7% to 6.4%) but not high enough for a diagnosis of diabetes. Individuals with prediabetes are at increased risk for developing Type 2 diabetes, heart disease, and stroke. Risk factors for developing prediabetes include age, overweight and obesity, hypertension and family history of diabetes. Diabetes Prevention Programs, also known as Lifestyle Change Programs, can help individuals with prediabetes prevent the onset of diabetes. Historically, no studies have investigated geographic disparities of prediabetes in Florida. Identifying geographic areas with increased burden of prediabetes can inform public health intervention and prevention efforts. Therefore, the objective of this study was to investigate the geographic distribution of prediabetes prevalence and to identify if certain areas have a statistically higher or lower burden of prediabetes.
METHODS: Self-reported prediabetes prevalence was analyzed from the 2013 Florida Behavioral Risk Factor Surveillance System data. Descriptive statistical analyses were performed using SAS 9.4. To assess geographic disparities, Geographical Information System (GIS) technology was used to develop chloropleth maps. Global Moran’s I was used to detect clustering of prediabetes prevalence. Additionally, local indicators of spatial association (LISA) were used to identify counties with significantly high prevalence proportions of prediabetes.
RESULTS: There were approximately 1,090,660 adults in Florida (7.2%) who reported having ever been diagnosed with prediabetes in 2013. Results indicate that many rural counties throughout the state tended to have higher prediabetes prevalence compared to urban areas. Prediabetes hotspots were identified in 5 counties in north Florida and prediabetes coldspots were identified in 6 counties in the southern part of the state.
CONCLUSIONS: The Florida Department of Health Bureau of Chronic Disease Prevention is working to increase the availability of, and physician referrals to, Lifestyle Change Programs. Geographic disparities of prediabetes prevalence exist in Florida. Identifying areas and populations with higher prevalence of prediabetes can inform public health prevention and intervention efforts. Findings suggest that the prevalence of prediabetes was typically higher in counties without Lifestyle Change Programs, demonstrating opportunities for prioritization.