title: Diabetes in US women on the rise independent of increasing BMI and other risk factors; a trend investigation of serial cross-sections.
abstract: BACKGROUND
  The epidemic of diabetes continues leaving an enormous and growing burden of chronic disease to public health. This study investigates this growing burden of diabetes independent of increasing BMI in a large population based female sample, 2006-2010.
  
  
  METHODS
  Serial cross-sectional data using the Behavioral Risk Factor Surveillance System (BRFSS) 2006-2010 surveys from 1,168,418 women. Diabetes was assessed by self-report of a physician diagnosis, and body mass index (BMI) was calculated based on self-reported height and weight.
  
  
  RESULTS
  Almost 60% of women responders had a BMI > 25 (defined as overweight or obese). Diabetes was reported in 16% of respondents whose BMI > 25, and in 4% of respondents with reported BMI ≤ 25. Overall, 11% of the women in this sample reported being diagnosed with diabetes, of whom 83% had a BMI > 25. BMI, physical activity, age, and race were each independently associated with diabetes (p-value < 0.05). The odds of reported diabetes increased each year independent of BMI, physical activity, age, and race.
  
  
  CONCLUSIONS
  After adjusting for age, race, physical activity, and year of survey response, results indicate a threefold increase in diabetes among respondents with a BMI > 25 (OR = 3.57; 95% CI = 3.52-3.63). Potentially more alarming was a notable increase in odds of diabetes across the years of study among women, implying a near 30 percent projected increase in odds of diabetes diagnoses by 2020. This is likely due to advances in diagnosis and treatment but also highlights a burden of disease that will have a growing and sustained impact on public health and healthcare systems.
authors.forename: Adaeze
authors.initials: A
authors.lastname: Ibe
authors.affiliation: Department of Community Health, School of Health and Human Services, National University Technology and Health Sciences Center, 3678 Aero Court, 92123 San Diego, CA, USA. tsmith@nu.edu.
authors.forename: Tyler C
authors.initials: TC
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D015992:Body Mass Index; D001835:Body Weight; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D050177:Overweight; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult