Tracking and monitoring diabetes prevalence

The Challenge 

Since 1980, the number of Americans diagnosed with diabetes has more than tripled, from 5.6 million to 20.9 million. States bear substantial responsibility for addressing the rising rates of diabetes and prediabetes in the U.S.  However, accurate state-level estimates of diabetes and prediabetes prevalence that include undiagnosed cases have been impossible to produce with traditional sources of state-level data.

A variety of new and nontraditional sources for state-level prevalence estimation are now available. These include
  • Surveys with expanded samples that can support state-level estimation for some states
  • Administrative and clinical data from insurance claims and electronic health records

These sources pose methodological challenges as they typically cover partial, sometimes nonrandom subpopulations, do not always include the same measurements on all individuals, and include different and limited sets of variables for case finding and adjustment.

The Centers for Disease Control and Prevention (CDC) asked Westat to develop a system for improving the ability of public health agencies to track and monitor diabetes prevalence and ABC control (A=Hemoglobin A1c, B=Blood pressure, and C=Cholesterol) among those with diabetes. This will be useful for targeting and evaluating the success of diabetes prevention and management programs.

Our Solutions 

  • Working with public health agencies in 10 jurisdictions, we assembled and combined data on diabetes and prediabetes from multiple sources, such as medical claims, electronic health records, and surveys.
  • Using a variety of statistical methods, we developed novel methods for estimating diabetes and prediabetes prevalence, including undiagnosed cases, at the state-level. Additionally, the study produced new state estimates of ABC control among people with diabetes.
  • The databases and methods we developed are generalizable to other states and data sources.
  • CDC and other stakeholders will be able to maintain and update the models as part of an enhanced approach to monitoring chronic diseases at the state and local levels.

The Results 

  • When the project is complete, CDC and state and local health agencies will be better able to monitor trends in the health indicators of diabetes, prediabetes and, eventually, other chronic diseases.
  • This information will help these agencies target programs to protect populations from the effects of chronic diseases and save critical health care dollars.

Our Client 

Centers for Disease Control and Prevention (CDC)