Over 38% of U.S. adults have prediabetes, or elevated glucose levels linked to type 2 diabetes incidence. The U.S. Preventive Services Task Force recommends giving people who screen positive for prediabetes access to evidence-based prevention strategies such as the Diabetes Prevention Program (DPP) . However, there is little data on prediabetes case clusters (‘hotspots’) to guide in-person program placement and planning. We used ArcGIS software to geospatially map 760,044 adults ages 35-70 with an A1c or FPG screening test in 2019 to census tracts served by Kaiser Permanente Northern California, an integrated health care system with 4.5 million members. A total of 304,727 adults had prediabetes (40%) defined as A1c 5.7-6.4% or FPG 100-125 mg/dL. Seven prediabetes hotspots concentrated in Alameda, Fresno, Madera, Sacramento, San Joaquin, Santa Clara, and Solano counties emerged. Adults living in prediabetes hotspots were less likely to be non-Hispanic White (34% vs. 51%, p<.001) . Hotspots had lower mean Census tract-level median household income ($93,670 vs. $98,216, p<.05) and percent with a college degree or more (34% vs. 43%, p<.001) , but higher percent receiving Medicaid (27% vs. 21%, p<.001) . Prediabetes cases clustered in geographic hotspots with demographics that differed from other areas. Policy makers and health care providers can use this information to target diabetes prevention resources and outreach.


J. Schmittdiel: None. M. Yassin: None. L. A. Rodriguez: None. T. Thomas: None. T. Moin: None. A. G. Leggett: None. P. Sanchez: None. O. Duru: None.


National Institutes of Health (R18DK122372-01A1)

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