Health, United States is an annual report on trends in health statistics, find more information at http://www.cdc.gov/nchs/hus.htm.

This dataset contains information on the total proportion of adults diagnosed with diabetes, collected from the system of health-related telephone surveys, the Behavioral Risk Factor Surveillance System (BRFSS), conducted in more than 400,000 patients, from 50 states in the US, the District of Columbia and three US territories.

Population-based county-level estimates for prevalence of DC were obtained from the Institute for Health Metrics and Evaluation (IHME) for the years 2004-2012 (16). DC prevalence rate was defined as the propor-tion of people within a county who had previously been diagnosed with diabetes (high fasting plasma glu-cose 126 mg/dL, hemoglobin A1c (HbA1c) of 6.5%, or diabetes diagnosis) but do not currently have high fasting plasma glucose or HbA1c for the period 2004-2012. DC prevalence estimates were calculated using a two-stage approach. The first stage used National Health and Nutrition Examination Survey (NHANES) data to predict high fasting plasma glucose (FPG) levels (≥126 mg/dL) and/or HbA1C levels (≥6.5% [48 mmol/mol]) based on self-reported demographic and behavioral characteristics (16). This model was then applied to Behavioral Risk Factor Surveillance System (BRFSS) data to impute high FPG and/or HbA1C status for each BRFSS respondent (16). The second stage used the imputed BRFSS data to fit a series of small area models, which were used to predict county-level prevalence of diabetes-related outcomes, including DC (16). The EQI was constructed for 2006-2010 for all US counties and is composed of five domains (air, water, built, land, and sociodemographic), each composed of variables to represent the environmental quality of that domain. Domain-specific EQIs were developed using principal components analysis (PCA) to reduce these variables within each domain while the overall EQI was constructed from a second PCA from these individual domains (L. C. Messer et al., 2014). To account for differences in environment across rural and urban counties, the overall and domain-specific EQIs were stratified by rural urban continuum codes (RUCCs) (U.S. Department of Agriculture, 2015). Results are reported as prevalence rate differences (PRD) with 95% confidence intervals (CIs) comparing the highest quintile/worst environmental quality to the lowest quintile/best environmental quality expo-sure metrics. PRDs are representative of the entire period of interest, 2004-2012. Due to availability of DC data and covariate data, not all counties were captured, however, the majority, 3134 of 3142 were utilized in the analysis. This dataset is not publicly accessible because: EPA cannot release personally identifiable information regarding living individuals, according to the Privacy Act and the Freedom of Information Act (FOIA). This dataset contains information about human research subjects. Because there is potential to identify individual participants and disclose personal information, either alone or in combination with other datasets, individual level data are not appropriate to post for public access. Restricted access may be granted to authorized persons by contacting the party listed. It can be accessed through the following means: Human health data are not available publicly. EQI data are available at: https://edg.epa.gov/data/Public/ORD/NHEERL/EQI. Format: Data are stored as csv files. This dataset is associated with the following publication: Jagai, J., A. Krajewski, K. Price, D. Lobdell, and R. Sargis. Diabetes control is associated with environmental quality in the USA. Endocrine Connections. BioScientifica Ltd., Bristol, UK, 10(9): 1018-1026, (2021).

Context

Diabetes is among the most prevalent chronic diseases in the United States, impacting millions of Americans each year and exerting a significant financial burden on the economy. Diabetes is a serious chronic disease in which individuals lose the ability to effectively regulate levels of glucose in the blood, and can lead to reduced quality of life and life expectancy. After different foods are broken down into sugars during digestion, the sugars are then released into the bloodstream. This signals the pancreas to release insulin. Insulin helps enable cells within the body to use those sugars in the bloodstream for energy. Diabetes is generally characterized by either the body not making enough insulin or being unable to use the insulin that is made as effectively as needed.

Complications like heart disease, vision loss, lower-limb amputation, and kidney disease are associated with chronically high levels of sugar remaining in the bloodstream for those with diabetes. While there is no cure for diabetes, strategies like losing weight, eating healthily, being active, and receiving medical treatments can mitigate the harms of this disease in many patients. Early diagnosis can lead to lifestyle changes and more effective treatment, making predictive models for diabetes risk important tools for public and public health officials.

The scale of this problem is also important to recognize. The Centers for Disease Control and Prevention has indicated that as of 2018, 34.2 million Americans have diabetes and 88 million have prediabetes. Furthermore, the CDC estimates that 1 in 5 diabetics, and roughly 8 in 10 prediabetics are unaware of their risk. While there are different types of diabetes, type II diabetes is the most common form and its prevalence varies by age, education, income, location, race, and other social determinants of health. Much of the burden of the disease falls on those of lower socioeconomic status as well. Diabetes also places a massive burden on the economy, with diagnosed diabetes costs of roughly $327 billion dollars and total costs with undiagnosed diabetes and prediabetes approaching $400 billion dollars annually.

Content

The Behavioral Risk Factor Surveillance System (BRFSS) is a health-related telephone survey that is collected annually by the CDC. Each year, the survey collects responses from over 400,000 Americans on health-related risk behaviors, chronic health conditions, and the use of preventative services. It has been conducted every year since 1984. For this project, a csv of the dataset available on Kaggle for the year 2015 was used. This original dataset contains responses from 441,455 individuals and has 330 features. These features are either questions directly asked of participants, or calculated variables based on individual participant responses.

This dataset contains 3 files: 1. diabetes _ 012 _ health _ indicators _ BRFSS2015.csv is a clean dataset of 253,680 survey responses to the CDC's BRFSS2015. The target variable Diabetes_012 has 3 classes. 0 is for no diabetes or only during pregnancy, 1 is for prediabetes, and 2 is for diabetes. There is class imbalance in this dataset. This dataset has 21 feature variables 2. diabetes _ binary _ 5050split _ health _ indicators _ BRFSS2015.csv is a clean dataset of 70,692 survey responses to the CDC's BRFSS2015. It has an equal 50-50 split of respondents with no diabetes and with either prediabetes or diabetes. The target variable Diabetes_binary has 2 classes. 0 is for no diabetes, and 1 is for prediabetes or diabetes. This dataset has 21 feature variables and is balanced. 3. diabetes _ binary _ health _ indicators _ BRFSS2015.csv is a clean dataset of 253,680 survey responses to the CDC's BRFSS2015. The target variable Diabetes_binary has 2 classes. 0 is for no diabetes, and 1 is for prediabetes or diabetes. This dataset has 21 feature variables and is not balanced.

Explore some of the following research questions: 1. Can survey questions from the BRFSS provide accurate predictions of whether an individual has diabetes? 2. What risk factors are most predictive of diabetes risk? 3. Can we use a subset of the risk factors to accurately predict whether an individual has diabetes? 4. Can we create a short form of questions from the BRFSS using feature selection to accurately predict if someone might have diabetes or is at high risk of diabetes?

Acknowledgements

It it important to reiterate that I did not create this dataset, it is just a cleaned and consolidated dataset created from the BRFSS 2015 dataset already on Kaggle. That dataset can be found here and the notebook I used for the data cleaning can be found here.

Inspiration

Zidian Xie et al fo...

It was estimated that as of 2023, around **** million people in the United States had been diagnosed with diabetes. The number of people diagnosed with diabetes in the U.S. has increased in recent years and the disease is now a major health issue. Diabetes is now the seventh leading cause of death in the United States, accounting for ******percent of all deaths. What is prediabetes? A person is considered to have prediabetes if their blood sugar levels are higher than normal but not high enough to be diagnosed with type 2 diabetes. As of 2021, it was estimated that around ** million men and ** million women in the United States had prediabetes. However, according to the CDC, around ** percent of these people do not know they have this condition. Not only does prediabetes increase the risk of developing type 2 diabetes, but also increases the risk of heart disease and stroke. The states with the highest share of adults who had ever been told they have prediabetes are California, Hawaii, and New Mexico. The prevalence of diabetes in the United States As of 2023, around *** percent of adults in the United States had been diagnosed with diabetes, an increase from ****percent in the year 2000. Diabetes is much more common among older adults, with around ** percent of those aged 60 years and older diagnosed with diabetes, compared to just ****percent of those aged 20 to 39 years. The states with the highest prevalence of diabetes among adults are West Virginia, Mississippi, and Louisiana, while Utah and Colorado report the lowest rates. In West Virginia, around ** percent of adults have been diagnosed with diabetes.

This is the Google Search interest data that powers the Visualisation Searching For Health. Google Trends data allows us to see what people are searching for at a very local level. This visualization tracks the top searches for common health issues in the United States, from Cancer to Diabetes, and compares them with the actual location of occurrences for those same health conditions to understand how search data reflects life for millions of Americans.

How does search interest for top health issues change over time? From 2004–2017, the data shows that search interest gradually increased over the past few years. Certain regions show a more significant increase in search interest than others. The increase in search activity is greatest in the Midwest and Northeast, while the changes are noticeably less dramatic in California, Texas, and Idaho. Are people generally becoming more aware of health conditions and health risks?

The search interest data was collected using the Google Trends API. The visualisation also brings in incidences of each condition so they can be compared. The health conditions were hand-selected from the Community Health Status Indicators (CHSI) which provides key indicators for local communities in the United States. The CHSI dataset includes more than 200 measures for each of the 3,141 United States counties. More information about the CHSI can be found on healthdata.gov.

Many striking similarities exist between searches and actual conditions—but the relationship between the Obesity and Diabetes maps stands out the most. “There are many risk factors for type 2 diabetes such as age, race, pregnancy, stress, certain medications, genetics or family history, high cholesterol and obesity. However, the single best predictor of type 2 diabetes is overweight or obesity. Almost 90% of people living with type 2 diabetes are overweight or have obesity. People who are overweight or have obesity have added pressure on their body's ability to use insulin to properly control blood sugar levels, and are therefore more likely to develop diabetes.” —Obesity Society via obesity.org

T1DiabetesGranada

A longitudinal multi-modal dataset of type 1 diabetes mellitus

Documented by:

Rodriguez-Leon, C., Aviles-Perez, M. D., Banos, O., Quesada-Charneco, M., Lopez-Ibarra, P. J., Villalonga, C., & Munoz-Torres, M. (2023). T1DiabetesGranada: a longitudinal multi-modal dataset of type 1 diabetes mellitus. Scientific Data, 10(1), 916. https://doi.org/10.1038/s41597-023-02737-4

Background

Type 1 diabetes mellitus (T1D) patients face daily difficulties in keeping their blood glucose levels within appropriate ranges. Several techniques and devices, such as flash glucose meters, have been developed to help T1D patients improve their quality of life. Most recently, the data collected via these devices is being used to train advanced artificial intelligence models to characterize the evolution of the disease and support its management. The main problem for the generation of these models is the scarcity of data, as most published works use private or artificially generated datasets. For this reason, this work presents T1DiabetesGranada, a open under specific permission longitudinal dataset that not only provides continuous glucose levels, but also patient demographic and clinical information. The dataset includes 257780 days of measurements over four years from 736 T1D patients from the province of Granada, Spain. This dataset progresses significantly beyond the state of the art as one the longest and largest open datasets of continuous glucose measurements, thus boosting the development of new artificial intelligence models for glucose level characterization and prediction.

Data Records

The data are stored in four comma-separated values (CSV) files which are available in T1DiabetesGranada.zip. These files are described in detail below.

Patient_info.csv

Patient_info.csv is the file containing information about the patients, such as demographic data, start and end dates of blood glucose level measurements and biochemical parameters, number of biochemical parameters or number of diagnostics. This file is composed of 736 records, one for each patient in the dataset, and includes the following variables:

Patient_ID – Unique identifier of the patient. Format: LIB19XXXX.

Sex – Sex of the patient. Values: F (for female), masculine (for male)

Birth_year – Year of birth of the patient. Format: YYYY.

Initial_measurement_date – Date of the first blood glucose level measurement of the patient in the Glucose_measurements.csv file. Format: YYYY-MM-DD.

Final_measurement_date – Date of the last blood glucose level measurement of the patient in the Glucose_measurements.csv file. Format: YYYY-MM-DD.

Number_of_days_with_measures – Number of days with blood glucose level measurements of the patient, extracted from the Glucose_measurements.csv file. Values: ranging from 8 to 1463.

Number_of_measurements – Number of blood glucose level measurements of the patient, extracted from the Glucose_measurements.csv file. Values: ranging from 400 to 137292.

Initial_biochemical_parameters_date – Date of the first biochemical test to measure some biochemical parameter of the patient, extracted from the Biochemical_parameters.csv file. Format: YYYY-MM-DD.

Final_biochemical_parameters_date – Date of the last biochemical test to measure some biochemical parameter of the patient, extracted from the Biochemical_parameters.csv file. Format: YYYY-MM-DD.

Number_of_biochemical_parameters – Number of biochemical parameters measured on the patient, extracted from the Biochemical_parameters.csv file. Values: ranging from 4 to 846.

Number_of_diagnostics – Number of diagnoses realized to the patient, extracted from the Diagnostics.csv file. Values: ranging from 1 to 24.

Glucose_measurements.csv

Glucose_measurements.csv is the file containing the continuous blood glucose level measurements of the patients. The file is composed of more than 22.6 million records that constitute the time series of continuous blood glucose level measurements. It includes the following variables:

Patient_ID – Unique identifier of the patient. Format: LIB19XXXX.

Measurement_date – Date of the blood glucose level measurement. Format: YYYY-MM-DD.

Measurement_time – Time of the blood glucose level measurement. Format: HH:MM:SS.

Measurement – Value of the blood glucose level measurement in mg/dL. Values: ranging from 40 to 500.

Biochemical_parameters.csv

Biochemical_parameters.csv is the file containing data of the biochemical tests performed on patients to measure their biochemical parameters. This file is composed of 87482 records and includes the following variables:

Patient_ID – Unique identifier of the patient. Format: LIB19XXXX.

Reception_date – Date of receipt in the laboratory of the sample to measure the biochemical parameter. Format: YYYY-MM-DD.

Name – Name of the measured biochemical parameter. Values: 'Potassium', 'HDL cholesterol', 'Gammaglutamyl Transferase (GGT)', 'Creatinine', 'Glucose', 'Uric acid', 'Triglycerides', 'Alanine transaminase (GPT)', 'Chlorine', 'Thyrotropin (TSH)', 'Sodium', 'Glycated hemoglobin (Ac)', 'Total cholesterol', 'Albumin (urine)', 'Creatinine (urine)', 'Insulin', 'IA ANTIBODIES'.

Value – Value of the biochemical parameter. Values: ranging from -4.0 to 6446.74.

Diagnostics.csv

Diagnostics.csv is the file containing diagnoses of diabetes mellitus complications or other diseases that patients have in addition to type 1 diabetes mellitus. This file is composed of 1757 records and includes the following variables:

Patient_ID – Unique identifier of the patient. Format: LIB19XXXX.

Code – ICD-9-CM diagnosis code. Values: subset of 594 of the ICD-9-CM codes (https://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/codes).

Description – ICD-9-CM long description. Values: subset of 594 of the ICD-9-CM long description (https://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/codes).

Technical Validation

Blood glucose level measurements are collected using FreeStyle Libre devices, which are widely used for healthcare in patients with T1D. Abbott Diabetes Care, Inc., Alameda, CA, USA, the manufacturer company, has conducted validation studies of these devices concluding that the measurements made by their sensors compare to YSI analyzer devices (Xylem Inc.), the gold standard, yielding results of 99.9% of the time within zones A and B of the consensus error grid. In addition, other studies external to the company concluded that the accuracy of the measurements is adequate.

Moreover, it was also checked in most cases the blood glucose level measurements per patient were continuous (i.e. a sample at least every 15 minutes) in the Glucose_measurements.csv file as they should be.

Usage Notes

For data downloading, it is necessary to be authenticated on the Zenodo platform, accept the Data Usage Agreement and send a request specifying full name, email, and the justification of the data use. This request will be processed by the Secretary of the Department of Computer Engineering, Automatics, and Robotics of the University of Granada and access to the dataset will be granted.

The files that compose the dataset are CSV type files delimited by commas and are available in T1DiabetesGranada.zip. A Jupyter Notebook (Python v. 3.8) with code that may help to a better understanding of the dataset, with graphics and statistics, is available in UsageNotes.zip.

Graphs_and_stats.ipynb

The Jupyter Notebook generates tables, graphs and statistics for a better understanding of the dataset. It has four main sections, one dedicated to each file in the dataset. In addition, it has useful functions such as calculating the patient age, deleting a patient list from a dataset file and leaving only a patient list in a dataset file.

Code Availability

The dataset was generated using some custom code located in CodeAvailability.zip. The code is provided as Jupyter Notebooks created with Python v. 3.8. The code was used to conduct tasks such as data curation and transformation, and variables extraction.

Original_patient_info_curation.ipynb

In the Jupyter Notebook is preprocessed the original file with patient data. Mainly irrelevant rows and columns are removed, and the sex variable is recoded.

Glucose_measurements_curation.ipynb

In the Jupyter Notebook is preprocessed the original file with the continuous glucose level measurements of the patients. Principally rows without information or duplicated rows are removed and the variable with the timestamp is transformed into two new variables, measurement date and measurement time.

Biochemical_parameters_curation.ipynb

In the Jupyter Notebook is preprocessed the original file with patient data of the biochemical tests performed on patients to measure their biochemical parameters. Mainly irrelevant rows and columns are removed and the variable with the name of the measured biochemical parameter is translated.

Diagnostic_curation.ipynb

In the Jupyter Notebook is preprocessed the original file with patient data of the diagnoses of diabetes mellitus complications or other diseases that patients have in addition to T1D.

Get_patient_info_variables.ipynb

In the Jupyter Notebook it is coded the feature extraction process from the files Glucose_measurements.csv, Biochemical_parameters.csv and Diagnostics.csv to complete the file Patient_info.csv. It is divided into six sections, the first three to extract the features from each of the mentioned files and the next three to add the extracted features to the resulting new file.

Data Usage Agreement

The conditions for use are as follows:

You confirm that you will not attempt to re-identify research participants for any reason, including for re-identification theory research.

You commit to keeping the T1DiabetesGranada dataset confidential and secure and will not redistribute data or Zenodo account credentials.

You will require

This subset of the community health indicator report data will not be updated. A dataset containing all of the community health indicators is now available. To view the latest community health obesity and diabetes related indicators, see the featured content section. This Obesity and Diabetes Related Indicators dataset provides a subset of data (40 indicators) for the two topics: Obesity and Diabetes. The dataset includes percentage or rate for Cirrhosis/Diabetes and Obesity and Related Indicators, where available, for all counties, regions and state.
New York State Community Health Indicator Reports (CHIRS) were developed in 2012, and annually updated to provide data for over 300 health indicators, organized by 15 health topic and data for all counties, regions and state are presented in table format with links to trend graphs and maps. Most recent county and state level data are provided. Multiple year combined data offers stable estimates for the burden and risk factors for these two health topics.

This dataset contains number and percentage of diabetes patients in the US during 2013 grouped by ZIP code. The prevalence and incidence of diabetes have increased in the United States in recent decades, no studies have systematically examined long-term, national trends in the prevalence and incidence of diagnosed diabetes. The prevalence of diabetes increased substantially between 2000 and 2007, mainly because there are more patients with a new diagnosis each year than those who die. The increase observed by 2007 almost reached the World Health Organization prediction for 2030.

According to the Juvenile Diabetes Research Foundation (JDRF), almost 1.25 million people in the United States (US) have type 1 diabetes, which makes them dependent on insulin injections. Nationwide, type 2 diabetes rates have nearly doubled in the past 20 years resulting in more than 29 million American adults with diabetes and another 86 million in a pre-diabetic state. The International Diabetes Federation (IDF)has estimated that there will be almost 650 million adult diabetic patients worldwide at the end of the next 20 years (excluding patients over the age of 80). At this time, pancreas transplantation is the only available cure for selected patients, but it is offered only to a small percentage of them due to organ shortage and the risks linked to immunosuppressive regimes. Currently, exogenous insulin therapy is still considered to be the gold standard when managing diabetes, though stem cell biology is recognized as one of the most promising strategies for restoring endocrine pancreatic function. However, many issues remain to be solved, and there are currently no recognized treatments for diabetes based on stem cells. In addition to stem cell research, severalβ-cell substitutive therapies have been explored in the recent era, including the use of acellular extracellular matrix scaffolding as a template for cellular seeding, thus providing an empty template to be repopulated with β-cells. Although this bioengineering approach still has to overcome important hurdles in regard to clinical application (including the origin of insulin producing cells as well as immune-related limitations), it could theoretically provide an inexhaustible source of bio-engineered pancreases

The Statewide Planning and Research Cooperative System (SPARCS) Inpatient De-identified dataset contains discharge level detail on patient characteristics, diagnoses, treatments, services, and charges. This data contains basic record level detail regarding the discharge; however the data does not contain protected health information (PHI) under Health Insurance Portability and Accountability Act (HIPAA). The health information is not individually identifiable; all data elements considered identifiable have been redacted. For example, the direct identifiers regarding a date have the day and month portion of the date removed. A downloadable file with this data is available for ease of download at: https://health.data.ny.gov/Health/Hospital-Inpatient-Discharges-SPARCS-De-Identified/3m9u-ws8e. For more information check out: http://www.health.ny.gov/statistics/sparcs/ or go to the “About” tab.

The Diabetes Prevention Program (DPP) is a clinical trial that investigated whether modest weight loss through dietary changes and increased physical activity or treatment with the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in high risk individuals with prediabetes.

The study enrolled overweight persons with elevated fasting and post-load plasma glucose concentrations. Participants were randomized to placebo, metformin (850 mg twice daily), or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The primary outcome measure was development of diabetes, diagnosed on the basis of an annual oral glucose-tolerance test or a semiannual fasting plasma glucose test, according to the 1997 criteria of the American Diabetes Association: a value for plasma glucose of 126 mg per deciliter (7.0 mmol per liter) or higher in the fasting state, or 200 mg per deciliter (11.1 mmol per liter) or higher two hours after a 75-g oral glucose load. Participation in DPP continued after a diagnosis of diabetes was made, although study medication was discontinued and participants were sent to their local primary care provider for treatment of diabetes once fasting glucose was > 140 mg/dl.

Results showed that both lifestyle changes and treatment with metformin reduced the incidence of diabetes in persons at high risk compared with placebo. Furthermore, the lifestyle intervention was more effective than metformin in preventing the onset of diabetes.

Supplemental measurements were collected using biospecimens that were obtained during the original DPP clinical trial. These measurements included antibodies, biomarkers, hormones, and vitamin D levels to assess the relationships between sex hormones, diabetes risk factors, and the progression to diabetes. The supplemental data showed that sex hormones were associated with diabetes risk in men, but these associations were not found in women. Furthermore, obesity and glycemia were more important predictors of diabetes risk than sex hormones.

This chart shows the rate of hospitalizations for short- term complications of diabetes for the most recent data year by age range and county. It also shows the 2017 objective by age range. This chart is based on one of three datasets related to the Prevention Agenda Tracking Indicators county level data posted on this site. Each dataset consists of county level data for 68 health tracking indicators and sub-indicators for the Prevention Agenda 2013-2017: New York State’s Health Improvement Plan. A health tracking indicator is a metric through which progress on a certain area of health improvement can be assessed. The indicators are organized by the Priority Area of the Prevention Agenda as well as the Focus Area under each Priority Area. Each dataset includes tracking indicators for the five Priority Areas of the Prevention Agenda 2013-2017. The most recent year dataset includes the most recent county level data for all indicators. The trend dataset includes the most recent county level data and historical data, where available. Each dataset also includes the Prevention Agenda 2017 state targets for the indicators. Sub-indicators are included in these datasets to measure health disparities among socioeconomic groups. For more information, check out: http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/ and https://www.health.ny.gov/PreventionAgendaDashboard. The "About" tab contains additional details concerning this dataset.

The Audit seeks to monitor these four complications: Did the patient require injectable rescue treatment for Hypoglycaemia (Hypo) more than 6 hours after admission? Was the patient diagnosed with new onset Diabetic KetoAcidosis (DKA) more than 24 hours after admission? Was the patient diagnosed with new onset Hyperglycaemic Hyperosmolar State (HHS) more than 24 hours after admission? Was the patient diagnosed with a new onset foot ulcer more than 72 hours after admissions?

The Rio Grande Valley (RGV) in South Texas has one of the highest prevalence of obesity and type 2 diabetes (T2D) in the United States (US). We report for the first time the T2D prevalence in persons with HIV (PWH) in the RGV and the interrelationship between T2D, cardiometabolic risk factors, HIV-related indices, and antiretroviral therapies (ART). The PWH in this study received medical care at Valley AIDS Council (VAC) clinic sites located in Harlingen and McAllen, Texas. Henceforth, this cohort will be referred to as Valley AIDS Council Cohort (VACC). Cross-sectional analyses were conducted using retrospective data obtained from 1,827 registries. It included demographic and anthropometric variables, cardiometabolic traits, and HIV-related virological and immunological indices. For descriptive statistics, we used mean values of the quantitative variables from unbalanced visits across 20 months. Robust regression methods were used to determine the associations. For comparisons, we used cardiometabolic trait data obtained from HIV-uninfected San Antonio Mexican American Family Studies (SAMAFS; N = 2,498), and the Mexican American population in the National Health and Nutrition Examination Survey (HHANES; N = 5,989). The prevalence of T2D in VACC was 51% compared to 27% in SAMAFS and 19% in HHANES, respectively. The PWH with T2D in VACC were younger (4.7 years) and had lower BMI (BMI 2.43 units less) when compared to SAMAFS individuals. In contrast, VACC individuals had increased blood pressure and dyslipidemia. The increased T2D prevalence in VACC was independent of BMI. Within the VACC, ART was associated with viral load and CD4+ T cell counts but not with metabolic dysfunction. Notably, we found that individuals with any INSTI combination had higher T2D risk: OR 2.08 (95%CI 1.67, 2.6; p < 0.001). In summary, our results suggest that VACC individuals may develop T2D at younger ages independent of obesity. The high burden of T2D in these individuals necessitates rigorously designed longitudinal studies to draw potential causal inferences and develop better treatment regimens.

Originally, the dataset come from the CDC and is a major part of the Behavioral Risk Factor Surveillance System (BRFSS), which conducts annual telephone surveys to gather data on the health status of U.S. residents. As the CDC describes: "Established in 1984 with 15 states, BRFSS now collects data in all 50 states as well as the District of Columbia and three U.S. territories. BRFSS completes more than 400,000 adult interviews each year, making it the largest continuously conducted health survey system in the world.". The most recent dataset (as of February 15, 2022) includes data from 2020. It consists of 401,958 rows and 279 columns. The vast majority of columns are questions asked to respondents about their health status, such as "Do you have serious difficulty walking or climbing stairs?" or "Have you smoked at least 100 cigarettes in your entire life? [Note: 5 packs = 100 cigarettes]".

To improve the efficiency and relevance of our analysis, we removed certain attributes from the original BRFSS dataset. Many of the 279 original attributes included administrative codes, metadata, or survey-specific variables that do not contribute meaningfully to heart disease prediction—such as respondent IDs, timestamps, state-level identifiers, and detailed lifestyle questions unrelated to cardiovascular health. By focusing on a carefully selected subset of 18 attributes directly linked to medical, behavioral, and demographic factors known to influence heart health, we streamlined the dataset. This not only reduced computational complexity but also improved model interpretability and performance by eliminating noise and irrelevant information. All predicting variables could be divided into 4 broad categories:

1. Demographic factors: sex, age category (14 levels), race, BMI (Body Mass Index)

2. Diseases: weather respondent ever had such diseases as asthma, skin cancer, diabetes, stroke or kidney disease (not including kidney stones, bladder infection or incontinence)

3. Unhealthy habits:

   • Smoking - respondents that smoked at least 100 cigarettes in their entire life (5 packs = 100 cigarettes)
   • Alcohol Drinking - heavy drinkers (adult men having more than 14 drinks per week and adult women having more than 7 drinks per week

4. General Health:

   • Difficulty Walking - weather respondent have serious difficulty walking or climbing stairs
   • Physical Activity - adults who reported doing physical activity or exercise during the past 30 days other than their regular job
   • Sleep Time - respondent’s reported average hours of sleep in a 24-hour period
   • Physical Health - number of days being physically ill or injured (0-30 days)
   • Mental Health - number of days having bad mental health (0-30 days)
   • General Health - respondents declared their health as ’Excellent’, ’Very good’, ’Good’ ,’Fair’ or ’Poor’

Below is a description of the features collected for each patient:

The United States self-monitoring blood glucose (SMBG) market, valued at $7.62 billion in 2025, is projected to experience robust growth, driven by the increasing prevalence of diabetes and the rising adoption of advanced SMBG devices. The market's Compound Annual Growth Rate (CAGR) of 6.40% from 2019 to 2024 indicates a steady expansion, which is expected to continue through 2033. Key growth drivers include the increasing diabetic population, particularly among older adults, the rising awareness about diabetes management, and technological advancements leading to more accurate, user-friendly, and convenient glucose monitoring devices. The market is segmented into glucometer devices, test strips, and lancets, with glucometer devices likely representing the largest segment due to the technological innovations leading to smaller, more sophisticated devices and integration with mobile apps for data tracking and management. Furthermore, the growing demand for continuous glucose monitoring (CGM) systems, though not explicitly stated in the provided data, is a significant emerging trend that is likely contributing to market expansion. While challenges exist, such as the high cost of treatment and the potential for inaccuracies with some devices, the market's overall trajectory remains positive due to the sustained need for effective diabetes management. The competitive landscape is characterized by established players like Abbott Diabetes Care, Roche Holding AG, and LifeScan, who hold significant market share. These companies are engaged in continuous innovation to maintain their market dominance by developing technologically advanced devices and expanding their global reach. Smaller companies contribute significantly to innovation and competition, particularly in the development of less expensive and more accessible devices. However, the market's success is closely tied to the broader healthcare landscape, including government regulations, insurance coverage policies, and public health initiatives aimed at diabetes prevention and management. Further research is required to fully quantify the impact of these factors on specific market segments and individual companies within the US SMBG market. Recent developments include: January, 2023: LifeScan announced that the peer-reviewed Journal of Diabetes Science and Technology published Improved Glycemic Control Using a Bluetooth Connected Blood Glucose Meter and a Mobile Diabetes App: Real-World Evidence From Over 144,000 People With Diabetes, detailing results from a retrospective analysis of real-world data from over 144,000 people with diabetes-one of the largest combined blood glucose meter and mobile diabetes app datasets ever published., January 20, 2022: Roche announced the launch of the COBAS pulse system in selected countries accepting the CE mark. The COBAS pulse system marks Roche Diagnostics' newest generation of connected point-of-care solutions for professional blood glucose management. The COBAS pulse system combines the form factor of a high-performance blood glucose meter with simple usability and expanded digital capabilities like those of a smartphone. Following first commercial availability under the CE mark in select markets, Roche plans to seek CE IVDR and FDA clearance for the Cobas Pulse System in other global markets.. Notable trends are: Rising Diabetes Prevalence in the United States.

This Data set is from the Behavioral Risk Factor Surveillance System survey of the United States. "The Behavioral Risk Factor Surveillance System (BRFSS) is the worlds largest, on-going telephone health survey system, tracking health conditions and risk behaviors in the United States yearly since 1984. Conducted by the 50 state health departments as well as those in the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands with support from the CDC, BRFSS provides state-specific information about issues such as asthma, diabetes, health care access, alcohol use, hypertension, obesity, cancer screening, nutrition and physical activity, tobacco use, and more." (http://www.cdc.gov/brfss/index.htm) Data URL: http://www.cdc.gov/brfss/maps/gis_data.htm All values a percentage from 0-100

The Diabetes Prevention Program (DPP) was a multicenter trial examining the ability of an intensive lifestyle program or treatment with metformin to prevent or delay the development of type 2 diabetes in high-risk individuals with prediabetes. The DPP study showed that both interventions reduced the incidence of diabetes in participants, compared with placebo; the lifestyle intervention proved more effective than metformin in preventing the onset of diabetes. The Diabetes Prevention Program Outcomes Study (DPPOS) is the long-term follow-up of the original DPP study. The DPPOS sought to evaluate the effects of the interventions on the further development of diabetes and diabetes complications, including retinopathy, microangiopathy, and cardiovascular disease.

All active DPP participants were eligible for continued follow-up, and 88% of DPP participants enrolled in DPPOS (910 participants from the lifestyle, 924 from the metformin, and 932 from the original placebo groups). On the basis of the benefits from the intensive lifestyle intervention in the DPP, all three groups were offered group-implemented lifestyle intervention. Placebo was discontinued in the placebo group, metformin treatment was continued in the original metformin group, with participants unmasked to assignment, and the original lifestyle intervention group was offered additional lifestyle support. Comprehensive annual and semi-annual assessments similar to those done in the DPP study continued in DPPOS and included physical measurements, medical history updates, adverse event assessment, medication adherence and dispensing, questionnaires, and an annual oral glucose tolerance test (OGTT). OGTTs were discontinued after a confirmed diagnosis of diabetes.

DPPOS found that prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years; the cumulative incidence of diabetes remained lowest in the lifestyle group.

Data collected after the final DPP Bridge visits in 2002 through February 2020 are available from the Repository.

This layer contains details about the prevalence of diabetes in adults in King County. It has been developed for the Determinant of Equity - Health and Human Services. It includes information about Diabetes Prevalence in Adults equity indicator. Fields describe the total adults ages 18+ (Denominator), number of adults were ever told by doctor, nurse, or other health professional that they have diabetes (does not include diabetes during pregnancy or pre-diabetes) (Numerator), the type of equity indicator being measured (Indicator), and the value that describes this measurement (Indicator Value).The data was compiled by Washington State Department of Health (DOH).Behavioral Risk Factor Surveillance System (BRFSS)For more information about King County's equity efforts, please see:Equity, Racial & Social Justice VisionOrdinance 16948 describing the determinates of equityDeterminants of Equity and Data Tool