Individual determinants associated with fasting glucose levels and environmental factors associated with diabetes prevalence
Diabetes has continued to increase amongst the U.S. population and is recognized as a global health issue. The first objective of this dissertation was to examine individual determinants associated with increasing fasting glucose levels. Analyses were carried out first for persons stratified by family history of diabetes. The results indicate that persons with a family history of diabetes have higher average fasting glucose levels and a higher proportion are obese than persons without familial history. The parameters most influential in increasing glucose levels for persons without family history of diabetes were older age followed by obesity. Among persons reporting familial history, advanced age followed by male sex were the most influential parameters associated with increasing fasting glucose levels. The next analyses employed similar models carried out by race/ethnicity and sex. The results underscored the importance of age, obesity, and sex, but varied in influence by race/ethnicity. In the first two analyses, males reported family history of diabetes less than females. The second objective explored contextual correlates and their relationship with diabetes prevalence across the contiguous U.S. and by region. Obesity prevalence and poverty rates were significantly associated with prevalence, regardless of region, while the influence of Hispanic and Black populations varied by area. This research employed multivariate regression analyses with standardized variables to identify the most influential parameters and variance explained.