Trend analysis of diagnosed diabetes prevalence among American Indian/Alaska native young adults--United States, 1994-2007.

OBJECTIVE: In this study, we build on the previous findings of increased diabetes prevalence among American Indian/Alaska Native (AI/AN) young adults, by studying the rate at which annual prevalence estimates of diagnosed diabetes increased from 1994 to 2007. DESIGN AND
SETTING: For this study, BRFSS data for 1994-2007 from the 50 states, District of Columbia, Puerto Rico, Guam, and the Virgin Islands were analyzed. PARTICIPANTS: Only non-institutionalized adults aged 18 years and older were eligible to participate in the Behavioral Risk Factor Surveillance System survey. MAIN OUTCOME MEASURES: To examine the existence and strength of a trend, we analyzed plots and Spearman's rank correlation coefficients of annual prevalence estimates for each group of young adults. Mantel-Haenszel tests were employed to study the relationship of diagnosed diabetes prevalence and race (AI/ AN, non-Hispanic White), while controlling for the time periods 1994-2000 and 2001-2007. To quantify increases in the disparity of diagnosed diabetes prevalence and race (AI/ AN, non-Hispanic White), odds risk ratio estimates were employed to approximate corresponding prevalence ratio estimates for the time periods 1994-2000 and 2001-2007.
RESULTS: Employing Spearman's test for trend resulted in observing, during 1994-2007, statistically significant increasing trends in the annual prevalence estimates of diagnosed diabetes among AI/AN and non-Hispanic White young adults. AI/AN young adults, on average, were 1.7 (95% CI; [1.12, 2.63]) times more likely than non-Hispanic White young adults to be diagnosed with diabetes during 1994-2000 and 2.5 (95% CI; [1.93, 3.32]) times more likely during 2001-2007.
CONCLUSION: The findings in this study suggests that the disparity in the estimated prevalence of diagnosed diabetes between AI/AN and NHW young adults widened steadily from 2001 to 2007.