Race, regionality and pre-diabetes in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study

• Prevalence of pre-diabetes was higher for blacks and whites in the Stroke Belt.
• Race was independently associated with pre-diabetes.
• The odds for diabetes in blacks and whites are higher in the Stroke Belt.
• Pre-diabetes may be a contributor to regional disparities of type 2 diabetes.

ObjectiveTo determine the association between race, region and pre-diabetes.MethodThe study used 2003–2007 United States baseline data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study for this cross-sectional analysis. Participants in this study were 45 years or older at recruitment. Logistic regression was used to assess whether race and region are associated with pre-diabetes independent of demographics, socioeconomic factors and risk factors.ResultsTwenty-four percent of the study participants (n = 19,889) had pre-diabetes. The odds ratio (95% confidence interval) for having pre-diabetes was 1.28 (1.19–1.36) for blacks relative to whites and 1.18 (1.10–1.26) for people living in the Stroke Belt region relative to the other parts of the United States. The odds of having pre-diabetes for Stroke Belt participants changed minimally after additional adjustment for race (OR = 1.20; 1.13–1.28), age and sex (OR = 1.24; 1.16–1.32), socioeconomic status (OR = 1.22; 1.15–1.31) and risk factors (OR = 1.26; 1.17–1.35). In the adjusted model, being black was independently associated with pre-diabetes (OR = 1.19; 1.10–1.28).ConclusionThe prevalence of pre-diabetes was higher for both blacks and whites living in the Stroke Belt relative to living outside the Stroke Belt, and the prevalence of pre-diabetes was higher for blacks independent of region.