ORIGINAL REPORTS:DIABETES TREND ANALYSIS OF DIAGNOSED DIABETES PREVALENCE AMONG AMERICAN INDIAN/ALASKA NATIVE YOUNG ADULTS —UNITED STATES, 1994–2007 Henry Roberts, PhD; Ruth Jiles, PhD; Ali Mokdad, PhD; Gloria Beckles, MD; Nilka Rios-Burrows, MPH Objective: In this study, we build on the previous findings of increased diabetes preva- lence among American Indian/Alaska Native (AI/AN) young adults, by studying the rate at which annual prevalence estimates of diagnosed diabetes increased from 1994 to 2007. Design and Setting: For this study, BRFSS data for 1994–2007 from the 50 states, District of Columbia, Puerto Rico, Guam, and the Virgin Islands were analyzed. Participants: Only non-institutionalized adults aged 18 years and older were eligible to participate in the Behavioral Risk Factor Surveillance System survey. Main Outcome Measures: To examine the existence and strength of a trend, we analyzed plots and Spearman’s rank correlation coeffi- cients of annual prevalence estimates for each group of young adults. Mantel-Haenszel tests were employed to study the relationship of diagnosed diabetes prevalence and race (AI/ AN, non-Hispanic White), while controlling for the time periods 1994–2000 and 2001– 2007. To quantify increases in the disparity of diagnosed diabetes prevalence and race (AI/ AN, non-Hispanic White), odds risk ratio estimates were employed to approximate corresponding prevalence ratio estimates for the time periods 1994–2000 and 2001– 2007. Results: Employing Spearman’s test for trend resulted in observing, during 1994–2007, statistically significant increasing trends in the annual prevalence estimates of diagnosed diabetes among AI/AN and non-Hispanic White young adults. AI/AN young adults, on average, were 1.7 (95%CI; [1.12, 2.63]) times more likely than non-Hispanic White young adults to be diagnosed with diabetes during 1994–2000 and 2.5 (95% CI;[1.93, 3.32]) times more likely during 2001–2007. Conclusion: The findings in this study suggests that the disparity in the estimated prevalence of diagnosed diabetes between AI/AN and NHW young adults widened steadily from 2001 to 2007. (Ethn Dis. 2009;19:276–279) Key Words: BRFSS, Diabetes, American Indian/Alaska Native INTRODUCTION American Indian/Alaska Native (AI/ AN) adults have been reported to be twice as likely as non-Hispanic White adults to have diabetes 1 and diabetes prevalence estimates among the Pima Indians of Arizona have been recorded as the highest in the world. 2 Diabetes is a disease that affects people of all ages; yet, recent studies have reported in- creased prevalence of diabetes in AI/AN children and young adults. 3 The public health implication of early onset of diabetes is an increase in the duration of diabetes and an increased risk of developing early onset of heart disease, loss of vision, and the amputation of limbs. 4 Young adults diagnosed with diabetes at age 20 are anticipated to lose, on average, approximately 17 potential years of life. 5 In this study, we build on the previous findings of increased diabetes prevalence among AI/AN young adults by studying the rate at which annual prevalence estimates of diagnosed dia- betes increased from 1994 to 2007. Of particular interest, is the extent that the disparity in the prevalence of diagnosed diabetes between AI/AN and non-His- panic White young adults has widened from 2001 to 2007. METHODS To evaluate trends in the prevalence of diagnosed diabetes among AI/AN young adults and, as a comparison population, non-Hispanic White young adults, cross- sectional data from the Behavioral Risk Factor Surveillance System (BRFSS) sur- veys were analyzed. BRFSS is a state- based, random-digit–dialed telephone survey of the noninstitutionalized, US civilian population aged $18 years. For this study, BRFSS data for 1994–2007 from the 50 states, District of Columbia, Puerto Rico, Guam, and the Virgin Islands were analyzed. Young adults were defined as per- sons aged 18–34 years. Respondents who reported being AI/AN and not of Hispanic, Latino, or Spanish descent were considered to be AI/AN; respon- dents who reported being White and not of Hispanic, Latino, or Spanish descent were considered to be non- Hispanic White. Diabetes status was Address correspondence and reprint requests to Henry Roberts, PhD; 1600 Clifton Road, Mailstop K66, Atlanta, GA 30333; 770-488-2515; 770-488-8150 (fax); hroberts@cdc.gov From the Centers for Disease Control and Prevention/ National Center for Chron- ic Disease and Health Promotion/ Division of Adult and Community Health (HR, RJ, AM), and the Centers for Disease Control and Prevention/ National Center for Chron- ic Disease and Health Promotion/ Division of Diabetes Translation (GB, NRB), Young adults diagnosed with diabetes at age 20 are anticipated to lose, on average, approximately 17 potential years of life. 5 276 Ethnicity & Disease, Volume 19, Summer 2009