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

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

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Multicenter Study

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

Angela D Liese et al. Health Place. 2010 May.

Abstract

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.

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Figures

Figure 1
Figure 1
Spatially smoothed relative risks of Type 1 diabetes mellitus 2002-2003 in 10-19 year olds in four geographic regions computed from Bayesian SPC model (Clockwise from upper left: Colorado, Ohio, Washington, South Carolina)
Figure 2
Figure 2
Spatially smoothed relative risks of Type 2 diabetes mellitus 2002-2003 in 10-19 year olds in four geographic regions computed from Bayesian SPC model Type 2 SPC (Clockwise from upper left: Colorado, Ohio, Washington, South Carolina)

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