title: Trends in diabetes incidence among 7 million insured adults, 2006-2011: the SUPREME-DM project.
abstract: 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.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Nichols
authors.forename: Emily B
authors.initials: EB
authors.lastname: Schroeder
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Karter
authors.forename: Edward W
authors.initials: EW
authors.lastname: Gregg
authors.forename: Jay
authors.initials: J
authors.lastname: Desai
authors.forename: Jean M
authors.initials: JM
authors.lastname: Lawrence
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: O'Connor
authors.forename: Stanley
authors.initials: S
authors.lastname: Xu
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Newton
authors.forename: Marsha A
authors.initials: MA
authors.lastname: Raebel
authors.forename: Ram D
authors.initials: RD
authors.lastname: Pathak
authors.forename: Beth
authors.initials: B
authors.lastname: Waitzfelder
authors.forename: Jodi
authors.initials: J
authors.lastname: Segal
authors.forename: Jennifer Elston
authors.initials: JE
authors.lastname: Lafata
authors.forename: Melissa G
authors.initials: MG
authors.lastname: Butler
authors.forename: H Lester
authors.initials: HL
authors.lastname: Kirchner
authors.forename: Abraham
authors.initials: A
authors.lastname: Thomas
authors.forename: John F
authors.initials: JF
authors.lastname: Steiner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001774:Blood Chemical Analysis / Q000639:trends*; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: diabetes mellitus; glycated hemoglobin; hemoglobin A1c; incidence; trends