Diabetes
in Texas
Prevalence
Data Limitations
Data Limitations
DATA LIMITATIONS/DISCLOSURE

All data presented in this presentation include both type 1 and type 2 diabetes.

Data from the Behavioral Risk Factor Surveillance System (BRFSS) are for persons who are
eighteen years of age and older. They do not include children.

Women who report diabetes only during pregnancy are not included in prevalence.

All reported rates (%) from the Behavioral Risk Factor Surveillance System are weighted for
Texas demographics and the probability of selection and thus are not derived from the simple
division of numerator and denominator cases.

Population data come from the Texas State Data Center, Office of the State Demographer,
Institute for Demographic and Socioeconomic Research, College of Business, University of
Texas at San Antonio. Population data use 0.5 migration scenario.

Mortality data are from the Texas Department of State of Health Services, Center for Health
Statistics.
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Diabetes in Texas, 2008*
Area
Prevalence*
Texas
9.7%
US
8.3%
*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are
eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those
who report that they have been told by a doctor that they have diabetes. Women who report diabetes only during
pregnancy are not included in prevalence. Note: All reported rates (%) are weighted for Texas demographics and the
probability of selection and thus are not derived from the simple division of numerator and denominator cases.
3
Prevalence of Diabetes, US and Texas, 1995 - 2008*
20
18
%
16
14
12
Texas
US
10
8
6
4
2
08
20
07
20
06
20
05
20
04
20
03
20
02
20
01
20
00
20
99
19
98
19
97
19
96
19
19
95
0
YEAR
*Source: CDC Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are
eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those
who report that they have been told by a doctor that they have diabetes.
4
Estimated* Number of Adult Texans with Diabetes, Diagnosed
and Undiagnosed, 2008
425,157
Undiagnosed
Diagnosed
1,720,338
2008 Texas Adult Population: 17,735,442 (Age 18 Years and Older, uses migration scenario 0.5.)
*Undiagnosed diabetes estimate based on 2003-20060 NHANES age-adjusted prevalence estimate of 2.5% for
persons twenty years of age and older. Diagnosed diabetes estimate based on 2008 Texas BRFSS, and use
migration scenario 0.5.
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Texas Projected Population Increase, 2040*
100,000,000
80,000,000
60,000,000
2008
35,761,159
40,000,000
27,879,449
20,000,000
17,735,442
2040
24,383,647
0
18+
All Ages
Estimated Number of People
*Uses migration scenario of 0.5. Includes male and female, all races/ethnicities.
Source: Texas State Data Center - Office of the State Demographer, Institute for Demographic and Socioeconomic
Research, College of Business, University of Texas at San Antonio.
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Texas Projected Population Increases by Race/Ethnicity,
2000-2040*
40,000,000
35,000,000
Population
30,000,000
25,000,000
20,000,000
Hispanic
15,000,000
Black, non-Hispanic
White, non-Hispanic
10,000,000
TOTAL
5,000,000
0
2000
2010
2020
2030
2040
YEAR
*Uses 0.5 migration scenario. Texas State Data Center - Office of
the State Demographer, Institute for Demographic and
Socioeconomic Research, College of Business, University of
Texas at San Antonio.
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Texas Projected Diabetes Cases 2000 - 2040*
Hispanic (Prevalence = 12.3%)
Black, non-Hispanic (Prevalence = 12.9%)
White, non-Hispanic (Prevalence = 8.5%)
TOTAL (Prevalence = 10.3%)
Number of Diabetes Cases
3,000,000
2,500,000
2,000,000
1,500,000
1,000,000
500,000
0
2000
2010
2020
2030
2040
YEAR
*Uses 2007 diabetes prevalence by race/ethnicity from BRFSS and population data from the Texas State Data
Center - Office of the State Demographer, Institute for Demographic and Socioeconomic Research. Uses 0.5
migration scenario.
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Diabetes Prevalence by Sex, Texas, 2008*
Prevalence
Estimated
Number of People
Male
9.8%
865,221
Female
9.7%
863,946
Gender
2008 Texas Diabetes Prevalence is 9.7%.
*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are
eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those
who report that they have been told by a doctor that they have diabetes.
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Diabetes Prevalence by Sex, 20 Years and Older,
United States, 2008*
Gender
Prevalence
Male
8.6%
Female
7.9%
*Source: CDC Behavioral Risk Factor Surveillance System, 2008, for persons who are eighteen years of age and older, and include both
Type 1 and Type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.
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Diabetes Prevalence by Race/Ethnicity, Texas, 2008*
Area: Texas
9.7%
1,205,993
Race/Ethnicity
Prevalence
Estimated # of People
White, non-Hispanic
8.3%
736,987
Black, non-Hispanic
13.0%
251,543
Hispanic
11.1%
680,351
Other
7.5%
59,389
*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008. Note: All reported
rates (%) are weighted for Texas demographics and the probability of selection and thus are not derived from the
simple division of numerator and denominator cases.
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2008 Texas Diabetes Prevalence* by Race/Ethnicity
and Age Group
White, nonHispanic
Age Group
Black, nonHispanic
Hispanic
Other
18 - 44
2.9
3.0
4.3
1.4
45 - 64
10.4
23.8
20.9
13.9
65+
17.0
33.5
34.8
28.7
Overall
8.3
13.0
11.1
8.1
*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008. Note: All reported
rates (%) are weighted for Texas demographics and the probability of selection and thus are not derived from the
simple division of numerator and denominator cases.
State Rate = 9.7%
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2004 - 2008 Texas Diabetes Prevalence by Race/Ethnicity*
Figure 2: 2004 - 2008 Texas Diabetes Prevalence by Race/Ethnicity 1
2004
2005
2006
2007
2008
50.0
40.0
%
30.0
20.0
10.0
11.4
7.1
7.5
7.8
8.5
13.1
10.3
12.6
8.3
13.0
7.9
8.1
8.0
12.3
11.1
0.0
White
African-American
Hispanic/Latino
Race/Ethnicity
*Source: 2008 Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, for persons who are
eighteen years of age and older. Data include both type 1 and type 2 diabetes. Persons with diabetes include those
who report that they have been told by a doctor that they have diabetes. Women who report diabetes only during
pregnancy are not included in prevalence.
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Diabetes Prevalence by Race/Ethnicity, United States, 2008*
Race/Ethnicity
Prevalence
White, non-Hispanic
7.4%
Black, non-Hispanic
13.1%
Hispanic
7.5%
Other
8.3%
Multiracial (chooses more than one category)
9.2%
2008 US Diabetes Prevalence is 8.3%.
*Source: CDC Behavioral Risk Factor Surveillance System, BRFSS Survey, 2008, for persons who are eighteen
years of age and older, and include both type 1 and type 2 Diabetes. Persons with diabetes include those who report
that they have been told by a doctor that they have diabetes.
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2008 Texas Diabetes Prevalence by Age Group*
Age Group
Prevalence
18-29 Years
1.8%
30-44 Years
4.6%
45-64 Years
14.6%
65+
22.7%
*Source: 2008 Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, for persons who are
eighteen years of age and older. Data include both type 1 and type 2 diabetes. Persons with diabetes include
those who report that they have been told by a doctor that they have diabetes. Women who report diabetes only
during pregnancy are not included in prevalence. Population data come from the Texas State Data Center, Office
of the State Demographer, Institute for Demographic and Socioeconomic Research, College of Business,
University of Texas at San Antonio.
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Diabetes Prevalence by Educational Level, Texas, 2008*
Educational Level
Prevalence
No High School Diploma
14.2%
High School Graduate
9.7%
Some College
9.8%
College +
6.9%
2008 Diabetes Prevalence for Texas is 9.7%.
*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are
eighteen years of age and older, and include both type 1 and type 2 Diabetes. Persons with diabetes include those
who report that they have been told by a doctor that they have diabetes.
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Diabetes Prevalence by Income Level, Texas, 2008*
Income Level
Prevalence
Less Than $25,000
14.2%
$25,000 thru $49,999
10.6%
$50,000 or more
6.0%
2008 Diabetes Prevalence for Texas is 9.7%.
*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are
eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those
who report that they have been told by a doctor that they have diabetes.
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Texas Death Certificates
• Uses ICD-10 for years 1999 and later.
• Uses E-CODES (External Cause of Injury) to classify leading cause of death.
• Diabetes Mellitus is E10 – E14.
• Required to be filed no later than 10 days
after death.
• Can be filled out by a variety of people:
– Physicians
– Nurses
– Funeral home directors
– Medical Examiners
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Texas Death Certificate
• How causes of death are reported:
– Immediate cause of death—occurred closest to the time of death.
– Underlying cause of death—initiated events leading to immediate
death. There can only be one.
– Contributing cause of death—significant diseases or conditions that
may have contributed to death but did not result in the underlying
cause of death. There can be multiple contributing causes.
19
Diabetes Mellitus – Underlying Cause of Death
2003-2006, Texas
20
Diabetes Mellitus – Underlying or Contributing Cause of Death
2003-2006, Texas
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Top Ten Leading Causes of Death, Texas, 2006*
Rank
Underlying Cause
Number of Deaths
1
Disease of the Heart
38,487
2
Malignant Neoplasms
34,776
3
Cerebrovascular Diseases
9,332
4
Accidents
9,006
5
Chronic Lower Respiratory Disease
7,599
6
Diabetes Mellitus
5,180
7
Alzheimer’s Disease
4,880
8
Influenza and Pneumonia
3,325
9
Nephritis, Nephrotic Syndrome and Nephrosis
2,967
10
Septicemia
2,649
All Other Causes
All Causes
38,324
156,525
*Source: Texas Department of State Health Services, Center for Health Statistics. Includes male and
female, all ages, and all races/ethnicities.
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Diabetes as a Cause of Death by Race/Ethnicity, Texas,
2006*
Race/Ethnicity
Rank
Number of Deaths
White, non-Hispanic
7
2,638
Black, non-Hispanic
5
884
Hispanic
5
1,549
Other
5
109
All
6
5,180
*Source:
Texas Department of State Health Services, Center for Health Statistics. Includes male and
female, all ages.
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Diabetes Mortality Rate (Per 100,000) by Race/Ethnicity,
Texas, 2006*
Mortality rates for each race/ethnicity were applied to the 2006 population by
race/ethnicity:
20 per 100,000 whites (non-Hispanic).
42 per 100,000 Hispanics.
49 per 100,000 blacks (non-Hispanic).
21 per 100,000 persons who fall in the “Other” category.
The 2006 mortality rates (per 100,000) for blacks (non-Hispanic) and
Hispanics were more than double that of whites (non-Hispanic).
*Source: Texas Department of State Health Services, Center for Health Statistics. Includes male and female, all ages.
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