Figure 1: Diabetes Prevalence among King County Adults by Region, 1995-2004

Figure 3: Diabetes Rate in King County by Physical Activity Level and Weight Status

Figure 2: Diabetes Death Rate in King County by Race/Ehnicity and by Neighborhood Poverty Level

Figures:  
• Figure 1: Diabetes Prevalence among King County Adults by Region, 1995-2004  – 
• Figure 3: Diabetes Rate in King County by Physical Activity Level and Weight Status  – 
• Figure 2: Diabetes Death Rate in King County by Race/Ehnicity and by Neighborhood Poverty Level

Data Discussion

The Indicator Defined

Percentage of people who are diagnosed with diabetes.

Data Interpretation/Evaluation

Diabetes is caused by a decreased ability to produce insulin (Type 1) or an impaired response to insulin (Type 2), leading to a high level of sugar in the blood. Of all diabetics, 90% have Type 2 diabetes. Due to the close link between obesity and the development of type 2 diabetes, this dual epidemic has been named “diabesity” by some health professionals.

Without proper treatment, diabetes can lead to serious complications such as kidney failure, blindness, and lower extremity amputation. In King County, diabetes prevalence rose from 2.7% in 1995-1997 to 5.2% during 2002-2004 and 5.8% in 2006. From 1995 to 2004, the prevalence of diabetes increased 2.9 times in King County (data not shown) and the increase was significant in all four regions (Figure 1). Averaged over 2000-2004, the South Region had the highest rate while the East Region had the lowest.

Diabetes is the seventh leading cause of death in King County. In 2003, there were 356 deaths with diabetes as the primary cause. In addition, 610 deaths occurred in 2003 in which diabetes was a contributing cause. (Data not shown) Beacon Hill/Georgetown/South Park, Southeast Seattle, Central Seattle, Southeast County, Tukwila/SeaTac had the highest diabetes death rates in the county.

American Indian/Alaska Natives and African Americans had substantially higher prevalence rate than the other racial/ethnic groups (data not shown). In King County, African Americans are 2.6 times more likely to be affected by diabetes than whites. People from lower income households had significantly higher prevalence than people from higher income households (data not shown). The death rates had similar racial/income disparities (Figure 2). The African American death rate from diabetes was 3.4 times the white rate while the American Indian/Alaska Native rate was 1.8 times the white rate. The age-adjusted diabetes death rate for African Americans in King County is 26% higher than the average rate for African Americans in the United States. A clear gradient by income levels in the death rate is also observed.

The prevalence of diabetes has been increasing locally, nationally, and worldwide. In King County, the prevalence doubled from 2.8% in 1996 to 5.8% in 2006. The rise in diabetes prevalence occurred at a time when the prevalence of obesity also increased. Other factors that are associated with diabetes and obesity include unhealthy eating and physical inactivity (Figure 3). Most cases of diabetes are potentially preventable through decreasing obesity and increasing physical activity in the population. However, obesity is becoming increasingly common, suggesting that the diabetes prevalence will continue to increase in the future.

Data Source and Limitations

Data discussion and figures are extracted from Seattle King County Public Health reports by Sustainable Seattle.  Figures 1 and 2 are produced in the Health of King County Report 2006.  Figure 3 is produced in the April 2007 Diabetes in King County report.  Data are based on data from the Washington State and national Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is a random telephone interview survey of non-institutionalized adults age 18 and older that has been conducted in King County every year since 1987.   

The prevalence rate is age-adjusted to the 2000 US population.  Differences in prevalence of diabetes by race/ethnicity were not statistically significant because of small sample sizes in the BRFSS data.  

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