Diabetes is a major cause of morbidity and mortality in the United States, resulting in substantial human and economic costs. National survey data indicate that the incidence of diagnosed diabetes in the United States has increased rapidly and that obesity is a major predictor of diabetes incidence. However, data on diabetes incidence have not been analyzed by state. To assess the geographic distribution of diagnosed diabetes and to examine state-specific changes, CDC analyzed data from Behavioral Risk Factor Surveillance System (BRFSS) surveys for the periods 1995-1997 and 2005-2007. This report summarizes the results of that analysis, which indicated that, during 2005-2007, average, annual age-adjusted incidence of diabetes ranged from 5.0 to 12.8 per 1,000 persons among 40 participating states, the District of Columbia (DC), and two territories, with the greatest incidence observed in the South and Puerto Rico. In addition, among 33 participating states with data for both periods, the age-adjusted incidence of diabetes increased 90% from 4.8 per 1,000 in 1995-1997 to 9.1 in 2005-2007. Among persons at risk, diabetes can be prevented or delayed by moderate weight loss and increased physical activity. Development and delivery of interventions that result in weight loss and increased physical activity among those at risk are needed to halt the increasing incidence of diabetes in U.S. states.