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In the Unites States, diabetes affects fourteen million people and is the fourth leading cause of death. The Centers for Disease Control and Prevention (CDC) (1993a), reported that in 1990, an estimated 78,000 individuals had diabetes in Hawaii, only half of whom had been diagnosed. Long term complications of diabetes include cardiovascular disease, stroke, hypertension, blindness, end-stage renal disease, neuropathy, amputations and birth defects in babies born to women with diabetes (NIH, 1994).
The purpose of this project was to identify trends in diabetes rates over the past eight years of BRFSS data collection (1986-1993).
Initiated in 1986 with the assistance of the CDC, the BRFSS was designed to collect heath risk behavior information from adult residents and monitor the prevalence of the behaviors over time. The sample population (1986-1993) included all state residents over age 18, except for institutionalized persons and on-base military personnel. Care must be taken when interpreting this self-reported diabetes data because there is no way to determine actual clinical cases of diabetes mellitus.
The original intent of this project was to identify trends in diabetes rates over the past eight years of BRFSS data collection (1986-1993). Self-reported diabetes is defined as any BRFSS respondent who answered 'yes' to the question about diabetes.


Table 6 and Figure 6 show the rates of self-reported diabetes (for those individuals 'at risk' for obesity) for each ethnicity and gender. Japanese residents had the highest prevalence of self-reported diabetes among all ethnic groups. Across all ethnic groups, females had a higher prevalence of self-reported diabetes than males if they were at risk for obesity. Risk of self-reported diabetes increases if respondents belong to the Japanese ethnicity group. These two two-way interaction terms were calculated from the above independent variables to identify any interaction between age group and gender on self-reported diabetes. All independent variables and interaction terms were entered into the analysis in one step.
This analysis was performed to identify risk factors for self-reported diabetes regardless of ethnicity.
Age, Gender, Obesity Risk, and the interaction terms of Age by Gender were all significantly associated with self-reported diabetes as in Analysis Number 1 and Analysis Number 2. Individuals 'at risk' for obesity had a higher risk of self-reported diabetes than individuals with no risk for obesity.


Risk of self-reported diabetes increased if respondents belonged to the Japanese ethnicity group. Based on pooled BRFSS survey responses (1988-1993), self-reported diabetes appeared in almost 6% of the surveyed population. Because there was only one question asked about diabetes, the assumption of this project was that a 'yes' responses equaled Type II diabetes.
Hawaiians, part-Hawaiians and Pacific Islanders have a known risk for obesity (OHA, 1994 and Hawaii State Health Department, 1986-1993). We know that the prevalence of diabetes is unevenly distributed across ethnic groups in Hawaii, particularly the Japanese (Wood, et. 18-44 years) and Gender was significantly associated with self-reported diabetes (p Table 8 provides the self-reported diabetes rates (per 1000 population) for Gender by Age Group with Figure 7 providing a graphical representation of this interaction. 120% or more above ideal body weight, were at greater risk of self-reported diabetes than those with no risk for obesity.



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