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Diabetes is a chronic disease that occurs when the body cannot produce or process insulin. A variety of environmental and behavioral factors increase the risk of developing type 2 diabetes and may be influenced by our built environment (e.g., physical activity, access to fresh foods, air quality).


Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin (type 1 diabetes) or when the body cannot effectively use the insulin it produces (type 2 diabetes). Increased risk for diabetes is primarily associated with age, ethnicity, family history of diabetes, smoking, obesity, and physical inactivity.

Human Health Mechanism

Diabetes impacts normal metabolic function due to the body’s inability to produce insulin or resistance to insulin action. Insulin allows the cells in the muscles, fat, and liver to absorb glucose from the blood, thus allowing blood glucose levels to remain stable. Without insulin, glucose remains in the blood stream causing hyperglycemia (i.e., high blood glucose levels). Hyperglycemia can damage the body’s organs overtime, especially targeting the kidney, eyes, feet, nerves, and heart function.

Indicator Measurement

Data are available through the Center for Disease Control and Prevention (CDC) PLACES public dashboard and are collected from the Behavioral Risk Factor Surveillance System (BRFSS), which is a state-based, telephone interview survey. BRFSS provides diabetes prevalence data by modeling the percentage of adults who report ever been told by a doctor, nurse, or other health professional that they have diabetes other than diabetes during pregnancy.

Related Health Outcomes & Exposures

Heart Disease, High Blood Pressure, Mental Distress, Physical distress, Physical Disability, Obesity, Physical Inactivity, PM2.5, Food Insecurity, Greenness (NDVI), Lack of Walkability, Smoking


Click here for References
  1. Diabetes Data Source: CDC PLACES: Diabetes. Data year 2020. Accessed April 2023.
  2. Amuda AT, Berkowitz SA. Diabetes and the Built Environment: Evidence and Policies. Curr Diab Rep. 2019;19(7):35. Published 2019 May 21. doi:10.1007/s11892-019-1162-1
  3. Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of Diabetes and Diabetes-Related Complications. Physical Therapy. 2008;88(11):1254-1264. doi: 2522/ptj.20080020
  4. Mouri MI, Badireddy M. Hyperglycemia. In: StatPearls. StatPearls Publishing. Treasure Island, FL, USA. Updated April 24, 2023. Available from:
  5. National Institution of Health (NIH). Symptoms & Causes of Diabetes. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Published December 2016.
  6. Valdez RB, Tabatabai M, Al-Hamdan MZ, et al. Association of diabetes and exposure to fine particulate matter (PM2.5) in the Southeastern United States. Hygiene and Environmental Health Advances. 2022;4:100024. doi:1016/j.heha.2022.100024