Online Program

331727
Prediabetes and comorbid Multiple Chronic Conditions among Adults in Texas: 2012-2013


Tuesday, November 3, 2015 : 1:06 p.m. - 1:24 p.m.

Suparna Bagchi, MSPH, DrPH, Health Promotion and Chronic Disease Prevention, Texas DSHS/CDC, Austin, TX

Background: In 2013, 11% of adults in Texas reported being diagnosed with diabetes and 7% of adults reported borderline diabetes (prediabetes). Prior literature indicates that adults with diabetes also have serious co-morbid multiple chronic conditions (MCCs), that complicate their care, treatment, and outcomes.  Few studies have measured the association between prediabetes and MCCs. Due to lack of Texas specific information on this relationship, we investigated the association between prediabetes and MCCs among adults, 18 years and older in Texas.

Methods: Combined data from 2012 and 2013 Texas Behavioral Risk Factor Surveillance System were analyzed. The dependent variable MCCs (value range 0-6, categorized as none, 1, 2, ≥3 chronic conditions) was defined from the following self-reported “doctor-diagnosed” conditions: cardiovascular disease, cancer, chronic obstructive pulmonary disease, kidney disease, arthritis and current asthma. Primary independent variable was pre-diabetes status derived from self-reported, pre-diabetes and the referent group was adults without diabetes or prediabetes. The analysis adjusted for age, sex, race, education, household income and body mass index. Chi-square was used to assess the associations between pre-diabetes status and comorbid MCCs. Weighted data analysis using the SAS surveyfreq procedure was conducted to account for complex survey design. Cumulative logit regression models were built to determine the adjusted odds ratios (aOR) and 95% Confidence Intervals (CI) between prediabetes status and MCCs after adjusting for potential confounding factors.

Results:  Approximately 10% of adults with prediabetes reported ≥3 comorbid MCCs compared to only 3% of adults without diabetes or prediabetes . Increasing age, female gender, Hispanic race, less than high school education, lower household income and obesity were significantly associated with a higher prevalence of MCCs. After adjusting for potential confounders, adults with prediabetes had roughly twice the increased odds (aOR: 1.9, 95% CI: 1.5-2.4) of reporting ≥3 comorbid MCCs as compared to adults without prediabetes or diabetes.

Conclusions: Comorbid MCCs were common among adults with prediabetes in Texas. Public health and lifestyle management interventions targeted towards adults with prediabetes might help in preventing onset of diabetes and comorbid MCCs and improve disease management and outcomes.

Learning Areas:

Chronic disease management and prevention
Epidemiology
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Describe the association between prediabetes and multiple comorbid health conditions among adults in Texas

Keyword(s): Chronic Disease Prevention, Chronic Disease Management and Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a CDC Chronic Disease Assignee epidemiologist to Texas, I work as a subject matter expert to several chronic disease programs in Texas. I have acquired the relevant training and public health practical experience.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.