Original Contribution Trends in Diabetes Incidence Among 7 Million Insured Adults, 2006–2011 The SUPREME-DM Project

An observational cohort analysis was conducted within the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) DataLink, a consortium of 11 integrated health-care delivery systems with elec-tronic health records in 10 US states. Among nearly 7 million adults aged 20 years or older, we estimated annual diabetes incidence per 1,000 persons overall and by age, sex, race/ethnicity, and body mass index. We identified 289,050 incident cases of diabetes. Age- and sex-adjusted population incidence was stable between 2006 and 2010, ranging from 10.3 per 1,000 adults (95 % confidence interval (CI): 9.8, 10.7) to 11.3 per 1,000 adults (95% CI: 11.0, 11.7). Adjusted incidence was significantly higher in 2011 (11.5, 95 % CI: 10.9, 12.0) than in the 2 years with the lowest incidence. A similar pattern was observed in most prespecified subgroups, but only the differences for persons who were not white were significant. In 2006, 56 % of incident cases had a glycated hemoglobin (hemoglobin A1c) test as one of the pair of events identifying diabetes. By 2011, that number was 74%. In conclu-sion, overall diabetes incidence in this population did not significantly increase between 2006 and 2010, but in-creases in hemoglobin A1c testing may have contributed to rising diabetes incidence among nonwhites in 2011. diabetes mellitus; glycated hemoglobin; hemoglobin A1c; incidence; trends Abbreviations: BMI, body mass index; CI, confidence interval; FPG, fasting plasma glucose; HbA1c, hemoglobin A1c; SUPREME-DM, Surveillance, Prevention, and Management of Diabetes Mellitus