Evaluating geographic variation in type 1 and type 2 diabetes mellitus incidence in youth in four US regions

Health Place. 2010 May;16(3):547-56. doi: 10.1016/j.healthplace.2009.12.015. Epub 2010 Jan 15.


We evaluated geographic variation in type 1 and type 2 diabetes mellitus (T1DM, T2DM) in four regions of the United States. Data on 807 incident T1DM cases diabetes and 313 T2DM cases occurring in 2002-03 in South Carolina (SC) and Colorado (CO), 5 counties in Washington (WA), and an 8 county region around Cincinnati, Ohio (OH) among youth aged 10-19 years were obtained from the SEARCH for Diabetes in Youth Study. Geographic patterns were evaluated in a Bayesian framework. Incidence rates differed between the study regions, even within race/ethnic groups. Significant small-area variation within study region was observed for T1DM and T2DM. Evidence for joint spatial correlation between T1DM and T2DM was present at the county level for SC (r(SC)=0.31) and CO non-Hispanic Whites (r(CO)=0.40) and CO Hispanics (r(CO)=0.72). At the tract level, no evidence for meaningful joint spatial correlation was observed (r(SC)=-0.02; r(CO)=-0.02; r(OH)=0.03; and r(WA=)0.09). Our study provides evidence for the presence of both regional and small area, localized variation in type 1 and type 2 incidence among youth aged 10-19 years in the United States.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Bayes Theorem
  • Child
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / ethnology
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / ethnology
  • Humans
  • Incidence
  • Residence Characteristics*
  • Risk
  • Small-Area Analysis
  • Topography, Medical*
  • United States / epidemiology
  • Young Adult