“We suspect there are cultural factors that are very hard to measure, for example traditional diet (or) attitudes toward seeking medical care” that would affect a person’s risk of diabetes, he said.

The diabetes belt overlaps considerably, though not completely, with the stroke belt and the recently defined heart failure belt (see Reuters Health story of February 2, 2011).

The CDC researchers said policy makers should now focus their efforts to prevent diabetes on those counties that need them the most, for instance by launching healthy-lifestyle and anti-obesity campaigns.

Dr. Lawrence Phillips, who studies diabetes at Emory University and was not involved in the current study, said the most important thing right now is for doctors to find those people in the diabetes belt who have the disease but haven’t been diagnosed, or have pre-diabetes and aren’t being treated.

The diabetes statistics in the study are likely an underestimate of the true prevalence of diabetes, Phillips said, because some people who were polled probably had diabetes but didn’t know it.

“Since diabetes is one of what we call the silent killer diseases ... it’s important for the public to be aware that this is a problem,” Phillips told Reuters Health. He said that having a defined diabetes belt should help highlight that message.

“What this does is to give health care providers ammunition,” Phillips said. “A provider can say, ‘We’re in the diabetes belt. All of these things are increased in part because of the way we live, and all of these things can be improved to a certain extent. Our risks can be decreased ... by eating healthier and to the extent that we can, being less sedentary.’”

SOURCE:American Journal of Preventive Medicine, online March 8, 2011.