While type 2 diabetes is one of the most common chronic diseases in the United States, nationwide figures for incidence are difficult to obtain. We used data from a large national health insurer (Clinformatics Data Mart Database, years 2001-2017) to estimate the incidence of type 2 diabetes by state of residence at first diagnosis. Cases were adults, ages 20 years, with type 2 diabetes (ICD-CM codes with antidiabetic medication). Individuals with type 1 diabetes or secondary diabetes were excluded. The incidence rate per 100,000 person-years ranged from 450.9 in Texas to 164.1 in South Dakota (incidence rate ratio (IRR) 2.7; 95% CI: 2.5, 3.1). The states with the highest incidence were Texas, Mississippi and Alabama. States with the lowest incidence included South Dakota, North Dakota and Massachusetts. For men, the incidence rate of type 2 diabetes ranged from 524.9 in Mississippi to 212.8 in North Dakota (IRR 2.5; 95% CI: 2.2, 2.8). There was greater variation in the incidence for women; it ranged from 409.2 in Alabama to 109.8 in South Dakota (IRR 3.7; 3.1, 4.5). The median age at diagnosis was 54 years in men and 56 years in women.

In conclusion, there is considerable interstate variability in the incidence of type 2 diabetes for the privately insured. Although many of the high incidence states were in the southern census region of the U.S., incidence rates were also high in Hawaii and Arizona.

M.A.M. Rogers: None. G. Imperatore: None. T. Basu: None. C. Kim: None. S.R. Benoit: None. D.B. Rolka: None. S. Saydah: None.


Centers for Disease Control and Prevention

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