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Diabetes

Diabetes occurs when the body does not produce enough insulin or cannot use its own insulin well enough to reduce sugar (glucose) levels in the blood. Adult, or type 2, diabetes occurs in adulthood, usually in people who are overweight or obese. Uncontrolled diabetes can lead to serious complications, such as blindness and other eye problems, kidney disease, neurological damage, hypertension, heart disease, stroke, and certain cancers. Uncontrolled diabetes can also cause poor circulation, which in turn can lead to foot amputation.1

More than two million adults in California have reported that they were diagnosed with diabetes in adulthood.2 Diabetes is the seventh leading cause of death in the United States, and accounts for more than 20% of health care spending.1

Before people develop type 2 diabetes, they almost always have prediabetes, a condition that is often undetected or not diagnosed.3 Prediabetes is associated with a higher risk for developing type 2 diabetes and cardiovascular disease. However, it can be reversed with diet, physical activity, and weight loss. Prediabetes therefore presents a prime opportunity for prevention.

Findings in Santa Barbara County

Measure

The prevalence of adult diabetes was measured by asking respondents if they had ever been told by a doctor or other health professional that they had diabetes (or “sugar diabetes;” female respondents were instructed to exclude pregnancy-related diabetes). Responses from persons who said they had "borderline" or "prediabetes" were added to the first question and combined for the final percentages in this section, as prediabetics are an important group to target for preventive interventions.

Table 16. Percentage of Adults With Diabetes or Prediabetes and Healthy People 2020 Target

2016 Santa Barbara
BRFSS
California*Health People 2020
Target
%(95% CI) % (95% CI)
Overall 10.1 (8.4–11.8) 12.9 (11.6–14.1)
Male 9.2 (6.8-11.7) 13.6 (11.9–15.2)
Female 11.0 (8.7–13.4) 12.2 (10.5–13.9)
7.2**
Hispanic 14.1 (10.6- 17.6) 14.1 (12.0–16.3)
Non-Hispanic White 7.5 (5.6–9.3) 10.7 (9.3–12.0)
Other 9.6 (4.6–14.5) NA

*2014 Behavioral Risk Factor Surveillance System.
**Target includes diabetes only
Note: Analyses in this Health Profile include adults with diabetes or prediabetes. The rate of diabetes in CA is 10.3% and prediabetes is 2.6%. In Santa Barbara County, the rate of diabetes is 8.8% and prediabetes is 1.3%.

Figure 47. Percentage of Self-Reported Diabetes or Prediabetes in Santa Barbara County, by Sex and Age

Percentage of Self-Reported Diabetes or Prediabetes in Santa Barbara County, by Sex and AgeClick to Enlarge

Figure 48. Percentage of Self-Reported Diabetes or Prediabetes in Santa Barbara County, by Race/Ethnicity, Educational Attainment, and Income

Percentage of Self-Reported Diabetes or Prediabetes in Santa Barbara County, by Race/Ethnicity, Educational Attainment, and IncomeClick to Enlarge

Health Disparities

At 10%, Santa Barbara County's percentage of adults with diabetes/prediabetes is lower than California's, but higher than the HP 2020 target of 7.2%. Approximately 1% of Santa Barbara County adults have been diagnosed with prediabetes. The percentages are notably higher among people over 65 and those in the lowest income group.

Hispanics, in particular, have the highest prevalence of adult diabetes among all groups in Santa Barbara County. Their rate is twice as high as that of whites and double the HP 2020 target.

Figure 49. Percentage of Santa Barbara County Adults Ever Told They Have Diabetes or Prediabetes, by County Subregion

Percentage of Santa Barbara County Adults Ever Told They Have Diabetes or Prediabetes, by County SubregionClick to Enlarge

Factors and Health Outcomes Associated with Diabetes

Figure 47 presents various individual, social, and environmental factors that contribute to the development of diabetes in the population, selected health outcomes that are associated with diabetes, and factors that contribute to successful management of the disease.

Modifiable risk factors for diabetes include diet, being overweight and obese, and insufficient physical activity.1 The figure compares people who have diabetes or prediabetes with all adults in the Santa Barbara County survey and with Californians as a whole.

Figure 50. Health and Risk Factors of Adults in Santa Barbara County with Diabetes or Prediabetes (10.1%), Compared With All Santa Barbara County Adults and Californians* as a Whole

Health and Risk Factors of Adults in Santa Barbara with Diabetes or Prediabetes (10.1%), Compared With All Santa Barbara Adults and Californians* as a WholeClick to Enlarge

*Data for California are not available for all indicators

The chart shows that there are some significant differences between Santa Barbara County and California overall. Twice as many Santa Barbara County adults with diabetes or prediabetes report poor health, as well as higher rates of strokes, cancer, and mental health issues. They are more likely to be obese, less likely to have a high school degree, and experience higher rates of food insecurity relative to Santa Barbara County overall. However, they are more likely to have a primary care provider.

Key Opportunities for Population Health Improvement

What Businesses Can Do

  • Help employees lose weight and increase physical activity levels to prevent diabetes through a worksite wellness program.4
  • Teach employees about diabetes and other diabetes-related diseases.5

http://www.countyhealthrankings.org/policies/worksite-obesity-prevention-interventions
http://www.businessgrouphealth.org/resources/topics/diabetes.cfm

What Healthcare Providers Can Do

  • Screen for prediabetes or diabetes.6
  • Use computerized clinical decision support systems.7
  • Refer patients to CDC's Diabetes Prevention Program,8 or other lifestyle change programs for prediabetes, such as the Stanford Chronic Disease Self-Management Program's module on diabetes,9 or other diabetes self-management education programs.10

http://www.countyhealthrankings.org/policies/computerized-clinical-decision-support-systems-cdss
http://www.partners.org/cird/pdfs/CITL_ITDM_Report.pdf
https://www.cdc.gov/diabetes/prevention/index.html
http://patienteducation.stanford.edu/programs/diabeteseng.html
10 https://www.thecommunityguide.org/diabetes/selfmgmteducation.html

What Individuals Can Do

  • Take an online test to find your risk for diabetes at https://doihaveprediabetes.org/.11 The test is offered in English and Spanish.
  • Find a CDC-recognized diabetes prevention program near you.12
  • Get at least 150 minutes of moderate activity or 75 minutes of vigorous activity per week, and 2 days of strength training per week.13
  • Take advantage of community fitness programs, such as the Channel Islands YMCA, and exercise classes.14
  • Keep a healthy weight by balancing calories eaten and calories burned in physical activity; choose a healthy diet with mostly whole grains, fruits, vegetables, lean protein, low-fat and fat-free dairy products, and drinking water.15

11 https://doihaveprediabetes.org/
12 https://nccd.cdc.gov/DDT_DPRP/Programs.aspx
13 https://health.gov/paguidelines/guidelines/
14 http://www.countyhealthrankings.org/policies/community-based-social-support-physical-activity
15 https://health.gov/dietaryguidelines/2010/


1 Centers for Disease Control and Prevention. (2016a). Diabetes: Working to reverse the U.S. epidemic [Fact sheet]. Retrieved from http://www.cdc.gov/chronicdisease/resources/publications/aag/diabetes.htm
2 University of California, Los Angeles Center for Health Policy Research. (n.d.). California Health Interview Survey. Retrieved from http://healthpolicy.ucla.edu/chis/Pages/default.aspx
3
American Diabetes Association. (2016). Diagnosing diabetes and learning about prediabetes. Retrieved from http://www.diabetes.org/diabetes-basics/diagnosis


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