Forecasting Diabetes Prevalence in California: A Microsimulation || Preventing Chronic Disease: July 2011: 10_0177

ORIGINAL RESEARCH
Forecasting Diabetes Prevalence in California: A Microsimulation
Lu Shi, PhD; Jeroen van Meijgaard, PhD; Jonathan Fielding, MD, MPH, MBA

Suggested citation for this article: Shi L, van Meijgaard J, Fielding J. Forecasting diabetes prevalence in California: a microsimulation. Prev Chronic Dis 2011;8(4):A80. http://www.cdc.gov/pcd/issues/2011/jul/10_0177.htm. Accessed [date].

PEER REVIEWED

Abstract
Introduction
Setting a goal for controlling type 2 diabetes is important for planning health interventions. The purpose of this study was to explore what may be a feasible goal for type 2 diabetes prevention in California.

Methods
We used the UCLA Health Forecasting Tool, a microsimulation model that simulates individual life courses in the population, to forecast the prevalence of type 2 diabetes in California’s adult population in 2020. The first scenario assumes no further increases in average body mass index (BMI) for cohorts entering adolescence after 2003. The second scenario assumes a gradual BMI decrease for children entering adolescence after 2010. The third scenario builds on the second by extending the same BMI decrease to people aged 12 to 65 years. The fourth scenario builds on the third by eliminating racial/ethnic disparities in physical activity.

Results
We found the predicted diabetes prevalence of the first, second, third, and fourth scenarios in 2020 to be 9.93%, 9.91%, 9.76%, and 9.77%, respectively. We found obesity prevalence for type 2 diabetes patients in 2020 to be 34.2%, 34.0%, 25.7%, and 25.6% for the 4 scenarios. Life expectancy in the third (80.56 y) and fourth (80.94 y) scenarios compared favorably with that of the first (80.32 y) and second (80.32 y) scenarios.

Conclusion
For the next 10 years, behavioral risk factor modifications are more likely to affect obesity prevalence and life expectancy in the general population and obesity prevalence among diabetic patients than to alter type 2 diabetes prevalence in the general population. We suggest setting more specific goals for reducing the prevalence of diabetes, such as reducing obesity-related diabetes complications, which may be more feasible and easier to evaluate than the omnibus goal of lowering overall type 2 diabetes prevalence by 2020.

full-text:
Preventing Chronic Disease: July 2011: 10_0177


Author Information
Corresponding Author: Lu Shi, PhD, Senior Analyst, University of California Los Angeles (UCLA) School of Public Health, 61-253 CHS, Box 951772, Los Angeles, CA 90095-1772. Telephone: 310-206-1141. E-mail: lshi@ph.ucla.edu.

Author Affiliations: Jeroen van Meijgaard, Jonathan Fielding, UCLA School of Public Health, Los Angeles, California.