AUTHOR=Huang Yue , Xu Yaqing , Qiao Yongxia , Wang Hui , Zhong Victor W. 

TITLE=Quantifying the contribution of 31 risk factors to the increasing prevalence of diabetes among US adults, 2005–2018

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1174632

DOI=10.3389/fpubh.2023.1174632

ISSN=2296-2565

ABSTRACT=Introduction: No study has comprehensively quantified individual and collective contribution of various risk factors to the growing burden of diabetes in the US.

Methods: This study aimed to determine the extent to which the increase in prevalence of diabetes was related to concurrent changes in the distribution of diabetes-related risk factors among US adults (aged 20 years or greater and not pregnant). Seven cycles of serial cross-sectional National Health and Nutrition Examination Survey data between 2005-2006 and 2017-2018 were included. The exposures were survey cycles and seven domains of risk factors including genetic, demographic, social determinants of health, lifestyle, obesity, biological and psychosocial domains. Using Poisson regressions, percent reduction in the β coefficient (the logarithm used to calculate the prevalence ratio for prevalence of diabetes in 2017-2018 vs 2005-2006) was computed to assess the individual and collective contribution of the 31 prespecified risk factors and seven domains to the growing burden of diabetes.

Results: Of the 16 091 participants included, the unadjusted prevalence of diabetes increased from 12.2% in 2005-2006 to 17.1% in 2017-2018 (prevalence ratio, 1.40 [95% CI, 1.14-1.72]). Individually, genetic domain (17.3%, [95% CI, 5.4%-40.8%]), demographic domain (41.5%, [95% CI, 24.4%-76.8%]), obesity domain (35.3%, [95% CI, 15.8%-70.2%]), biological domain (46.2%, [95% CI, 21.6%-79.1%]) and psychosocial domain (21.3%, [95% CI, 9.5%-40.1%]) were significantly associated with different percent reduction in β. After adjusting for all seven domains, the percent reduction in β was 97.3% [95% CI, 62.7%-164.8%].

Conclusions: The concurrently changing risk factors accounted for the increasing diabetes prevalence. However, the contribution of each risk factor domain varied. Findings may inform planning cost-effective and targeted public health programs for diabetes prevention.