Diabetes Initiative of South Carolina Surveillance Council Friday, June 3, Medical Park Columbia, SC 11:00 am 12:30 pm

Transcription

1 Diabetes Initiative of South Carolina Surveillance Council Friday, June 3, Medical Park Columbia, SC 11: am 12:3 pm Time Agenda Item Discussion Lead 11: Welcome and Introductions J. Vena/ K. Hunt Follow-up 11:5 Approval of the Minutes J. Vena/ K. Hunt 11:45 Strategic Plan Priorities Review J. Vena/ K. Hunt 12: Burden of Diabetes in SC Review of Slides J. Vena/ K. Hunt 12:3 Adjourn J. Vena/ K. Hunt

2 SURVEILLANCE COUNCIL Minutes March 4, : am 12:3 pm 96 Jonathan Lucas Street, Room 816 Charleston, SC Attending: Members: P. Arnold, E. Todd-Heckel, K. Heidari, K. Hermayer, K. Hunt, C. Jenkins, U. Lilavivat, S. Stinson, J. Vena, L. Chen Members via phone: None Guests: K. Linville, F. King, K. Piezer, S. Eubanks John Vena, PhD called the meeting to order at 11:1 am. I. The minutes from the December 4, 215 meeting were approved. II. Dr. Vena reviewed the DHEC data sheets Diabetes Impact in SC and Prediabetes in SC. There is concern of underestimates in the prevalence due to the data being self-reported. The Council will look at other data options around the state for pre-diabetes, and explore ways to tie together the efforts of the Surveillance and Outreach Councils. It was questioned if the Guidelines have had an impact on screening and prevalence. III. Khosrow Heidari reviewed a handout on the 1 leading causes of death by age group in SC from 214. IV. Dr. Vena reviewed the priorities for the Strategic Plan, and asked members to review and send comments/suggestions. V. HSSC Project: Discussion on how HSSC can better capture data on pre-diabetes. Dr. Hermayer noted that Brent Egan with the Hypertension Initiative is the only person who would have that data outside of the 5 hospitals participating in the data submission. Dr. Lilavivat would like to develop an app for collecting data. The meeting was adjourned at 12:29 pm Respectfully submitted, John Vena, PhD Future meeting dates: Friday, June 3, 216 in Columbia Friday, September 2, 216 in Charleston Friday, December 2, 216 in Columbia 1

3 DIABETES INITIATIVE OF SOUTH CAROLINA SURVEILLANCE COUNCIL QUARTERLY REPORT March May 216 Diabetes Fall Symposium articles for the American Journal of Medical Sciences Symposium edition were published in April. The following articles were submitted by DSC members and accepted published in the Journal: - Heidari K, Breneman CB, Barton ER, Fogner A, Callahan K, Diedhiou A. South Carolina: 2 Years of Diabetes A Public Health Concern. - Walker RJ, Strom Williams J, Egede LE. Influence of Race, Ethnicity and Social Determinants of Health on Diabetes Outcomes. - Shearer JE, Jenkins CH, Magwood GS, Pope CA. Contested Ownership of Disease and Ambulatory-Sensitive Emergency Department Visits for Type 2 Diabetes. The annual DSC Diabetes Under the Dome event was held on Wednesday, March 16, 216 at the SC Statehouse. Legislators and diabetes advocates gathered at the Statehouse to focus attention on diabetes awareness and the increasing number of South Carolinians diagnosed with diabetes. Fifty-seven legislators and staff were assessed for A1c, lipids, height, weight, BMI, BP and waist circumference. Volunteer healthcare professionals were on hand from DSC, MUSC, Fortis College, Presbyterian College of Pharmacy, USC, Palmetto Health, and Novo Nordisk. A Press Conference was held at 9:3am, followed by a Meet and Greet with Governor Nikki Haley. DHEC s 14 th Annual Chronic Disease Prevention Symposium was held in Myrtle Beach on March 11 12, 216. This year s program concentrated on a team based approach for chronic disease prevention and management.

4 Taken from the DHEC June Quarterly DSC Board Report II. Diabetes Surveillance Systems: Goal: Monitor the statewide diabetes burden and identify gaps to assist with planning, decision-making, and evaluation. Last week, CDC released the county level estimates for diabetes prevalence. The SC two highest counties with diabetes prevalence are Allendale (17.4%) and Fairfield (15.5%) and the two lowest are Beaufort (8%) and Lexington (9%) based on three year average -214, BRFSS. See the motion chart tab at - Motion Chart by County (Three-Year Age-Adjusted Prevalence % Adults). A copy of the NDPP with a set of push pins appears below with an overlay of prediabetes prevalence by county (three-year average prevalence). The 135 evaluation team began working through recommendations and/or corrections identified by CDC during the 135 Year 4 Technical Review process. Final revisions were due May 3, 216. o Updated information was needed to truly reflect statewide data o YRBS data was updated o Other data was updated to accommodate the changes outlined by CDC

5 Burden of Diabetes in SC DSC Surveillance Council Burden of Diabetes in the United States National Health and Nutrition Examination Survey (NHANES) Population based nationally representative sample of the United States population Diabetes Self reported doctor diagnosed diabetes Undiagnosed diabetes HbA1c 6.5%; or fasting plasma glucose 126 mg/dl 1

6 Burden of Diabetes in the United States NHANES: 9.2% self reported diagnosed diabetes 3.1% undiagnosed diabetes 12.3% overall total diabetes prevalence 25.2% of all diabetes is undiagnosed 36.5% have pre diabetes HbA1c of 5.7% to 6.4% fasting plasma glucose mg/dl Burden of Diabetes in the United States CDC Behavioral Risk Factor Surveillance System (BRFSS) BRFSS is an ongoing, state based telephone survey of the adult population Diabetes was defined based on responding yes to: "Has a doctor ever told you that you have diabetes? 2

7 Prevalence of Self Reported Diabetes by County: Prevalence of Self Reported Diabetes by County: 3

8 Prevalence of Self Reported Diabetes by County: 4

9 State Ranking: Age Adjusted Diagnosed Diabetes 1. Mississippi, 11.7% 2. Louisiana, 11.5% 3. West Virginia, 11.1% 4. Alabama, 11.1% 5. Tennessee, 1.8% 6. Oklahoma, 1.6% 7. Texas, 1.6% 8. South Carolina, 1.7% 9. Ohio, 1.4% 1. Arkansas, 1.2% West Virginia, 12.% 2. Mississippi, 11.9% 3. Alabama, 11.8% 4. Tennessee, 11.7% 5. Arkansas, 11.5% 6. Kentucky, 11.3% 7. Georgia, 11.% 8. Oklahoma, 1.9% 9. Texas, 1.8% 1. South Carolina, 1.7% Obesity Prevalence by County: 5

10 Obesity Prevalence by County: Obesity Prevalence by County: 6

11 Diabetes and Obesity County Motion Chart by County (Three Year Age Adjusted Prevalence % Adults) 7

12 Adult Self Reported Lifetime Diabetes Prevalence by Race and Gender, S.C TOTAL Black Female Black Male White Female White Male 2 Percent of Population Data Source: SC BRFSS; Generated by the Division of Chronic Disease Epidemiology Published in Heidari et al. (216) The American Journal of The Medical Sciences; 351(4). Data Source: SC Revenue & Fiscal Affairs Office Hospital Discharge Database DIABETES HOSPITALIZATIONS 8

13 Hospitalization Rates by Race and Sex, for Diabetes as Primary and/or Secondary Diagnoses, S.C Age Adjusted Rate per 1, population TOTAL Black Female Black Male White Female White Male Data Source: SC RFA; Generated by the Division of Chronic Disease Epidemiology Published in Heidari et al. (216) The American Journal of The Medical Sciences; 351(4). *Red line indicates a change in the number of secondary diagnoses used to calculate rates. Before, only 9 secondary diagnoses were available and then afterwards, the number of secondary diagnoses increased to 14. Data Source: SC Revenue & Fiscal Affairs Office Hospital Discharge DIABETES ED VISIT RATES 9

14 ED Rates by Race and Sex, for Diabetes as Primary and/or Secondary Diagnoses, S.C , Age Adjusted Rate per 1, Population 8, 7, 6, 5, 4, 3, 2, 1, TOTAL Black Female Black Male White Female White Male 214 Data Source: SC RFA; Generated by the Division of Chronic Disease Epidemiology Published in Heidari et al. (216) The American Journal of The Medical Sciences; 351(4). *Red line indicates a change in the number of secondary diagnoses used to calculate rates. Before, only 9 secondary diagnoses were available and then afterwards, the number of secondary diagnoses increased to 14. Data Source: SC Revenue & Fiscal Affairs Office DIABETES COMPLICATIONS 1

15 Lower Extremity Amputation Hospitalization Rates in Patients with Diabetes by Race and Gender, S.C Age Adjusted Rate per 1, population TOTAL Black Female Black Male White Female White Male Data Source: SC RFA; Generated by the Division of Chronic Disease Epidemiology May 215 *Red line indicates a change in the number of secondary diagnoses used to calculate rates. Before, only 9 secondary diagnoses were available and then afterwards, the number of secondary diagnoses increased to 14. ESRD Hospitalization Rates in Diabetes Patients by Race and Gender, S.C. 2 Age Adjusted Rate per 1, Population TOTAL Black Female Black Male White Female White Male Data Source: SC RFA; Generated by the Division of Chronic Disease Epidemiology May 215 *Red line indicates a change in the number of secondary diagnoses used to calculate rates. Before, only 9 secondary diagnoses were available and then afterwards, the number of secondary diagnoses increased to

16 Data Source: SC Vital Statistics DIABETES MORTALITY Age Adjusted Diabetes Mortality Rate by Race and Gender, Age Adjusted Rate per 1, population * 1996* 1997* 1998* TOTAL Black Female Black Male White Female White Male Data Source: SC Vital Statistics; Age adjusted to year 2 population *Adjusted by ICD9/ICD1 Comparability Ratio 1.82 March

17 Data Source: SC Revenue & Fiscal Affairs Office Hospital Discharge and SC Vital Records DIABETES DURING PREGNANCY 4,5 4, 3,5 Births to Mothers with Diabetes, S.C. 199 Number of Births 3, 2,5 2, 1,5 1, Gestational Pre Existing All Diabetes (mother) Data Source: SC Vital Records; Generated by the Division of Chronic Disease Epidemiology March

18 Percent of Births to Mothers with Diabetes, S.C. 8% 7% 6% Percent of Births 5% 4% 3% 2% 1% % TOTAL Black White Data Source: SC Vital Records; Generated by the Division of Chronic Disease Epidemiology March 215 Key Points SC diabetes burden continues to increase increased prevalence declining trends in mortality increased hospitalizations Increased emergency department visits Disparate proportion of the burden falls on the African American population higher prevalence and mortality higher comorbidity burden higher hospitalizations and ED visits Diabetes prevalence roughly 25% remains undiagnosed over one third of adults have pre diabetes 14

19 BACK UP Slides Diabetes Hospitalization Rates by Race and Sex, Primary Diagnoses, S.C. 5 Age Adjusted Rate per 1, population TOTAL Black Female Black Male White Female White Male Data Source: SC RFA; Generated by the Division of Chronic Disease Epidemiology April

20 Diabetes ED Visit Rates by Race and Gender Primary Diabetes Diagnoses, S.C. Age Adjusted Rate per 1, Population TOTAL Black Female Black Male White Female White Male Data Source: SC RFA; Generated by the Division of Chronic Disease Epidemiology May 215 *Red line indicates a change in the number of secondary diagnoses used to calculate rates. Before, only 9 secondary diagnoses were available and then afterwards, the number of secondary diagnoses increased to 14. Diabetes ED Visit Rates by Race and Gender Secondary Diabetes Diagnoses, S.C. 8, Age Adjusted Rate per 1, Population 7, 6, 5, 4, 3, 2, 1, TOTAL Black Female Black Male White Female White Male Data Source: SC RFA; Generated by the Division of Chronic Disease Epidemiology May 215 *Red line indicates a change in the number of secondary diagnoses used to calculate rates. Before, only 9 secondary diagnoses were available and then afterwards, the number of secondary diagnoses increased to

21 Data Source: SC Revenue & Fiscal Affairs Office Hospital Discharge Elixhauser Comorbidity Measure DIABETES AND COMORBIDITIES Hospitalization Rates for Diabetes as Primary Diagnosis by Number of Comorbidities, S.C Age Adjusted Rate per 1, Population comorbity 1 comorbidity 2 comorbities 3+ comorbidities Data Source: SC Revenue and Fiscal Affairs Office; Generated by the Division of Chronic Disease Epidemiology May 215 *Red line indicates a change in the number of secondary diagnoses used to calculate rates. Before, only 9 secondary diagnoses were available and then afterwards, the number of secondary diagnoses increased to

22 Diabetes Hospitalization Rates as the Primary Diagnosis with 3+ Comorbidities by Race and Gender, S.C Age Adjusted Rate per 1, Population TOTAL Black Female Black Male White Female White Male Data Source: SC RFA; Generated by the Division of Chronic Disease Epidemiology May 215 *Red line indicates a change in the number of secondary diagnoses used to calculate rates. Before, only 9 secondary diagnoses were available and then afterwards, the number of secondary diagnoses increased to Age Adjusted Hospitalization of Diabetic Ketoacidosis by Race and Gender, S.C. Age Adjusted Rate per 1, population TOTAL Black Female Black Male White Female White Male Data Source: SC RFA; Generated by the Division of Chronic Disease Epidemiology May 215 *Red line indicates a change in the number of secondary diagnoses used to calculate rates. Before, only 9 secondary diagnoses were available and then afterwards, the number of secondary diagnoses increased to