Aims and Scope

The Open Diabetes Journal is an open access online journal that publishes original research articles, reviews/mini-reviews, letters, and guest-edited single topic issues on all aspects of basic and clinical diabetes mellitus research. The journal scope includes diabetes pathogenesis, epidemiology, lipid disorders, gastrointestinal peptides and their vascular, metabolic and food intake effects, osteoporosis, interdisciplinary practices in endocrinology, complications, biochemical and molecular studies, clinical care, genetics, immunology, nutrition, psychosocial research, epidemiology, socio-economic research, drug pharmacology, treatment, and prevention. Diabetic complications such as retinopathy, neuropathy, nephropathy, renal failure and impotence, hypertension, hearing impairment, hyperlipidemia, obesity and other metabolic syndromes are also included. Topics related to pancreatic islet dysfunction and insulin resistance, adipose tissue function, and glucose homeostasis are also covered in the journal.

The Open Diabetes Journal, a peer-reviewed journal, is an important and reliable source of current information on developments in the field. The emphasis will be on the rapid publication of quality articles and making them freely available worldwide.

Editor's Choice

Spatial Clusters of County-Level Diagnosed Diabetes and Associated Risk Factors in the United States

Sundar S. Shrestha, Karen A. Kirtland, Theodore J. Thompson, Lawrence Barker, Edward W. Gregg, Linda Geiss


We examined whether spatial clusters of county-level diagnosed diabetes prevalence exist in the United States and whether socioeconomic and diabetes risk factors were associated with these clusters.

Materials and Methods:

We used estimated county-level age-adjusted data on diagnosed diabetes prevalence for adults in 3109 counties in the United States (2007 data). We identified four types of diabetes clusters based on spatial autocorrelations: high-prevalence counties with high-prevalence neighbors (High-High), low-prevalence counties with low-prevalence neighbors (Low-Low), low-prevalence counties with high-prevalence neighbors (Low-High), and highprevalence counties with low-prevalence neighbors (High-Low). We then estimated relative risks for clusters being associated with several socioeconomic and diabetesrisk factors.


Diabetes prevalence in 1551 counties was spatially associated (p<0.05) with prevalence in neighboring counties. The rate of obesity, physical inactivity, poverty, and the proportion of non-Hispanic blacks were associated with a county being in a High-High cluster versus being a non-cluster county (7% to 36% greater risk) or in a Low-Low cluster (13% to 67% greater risk). The percentage of non-Hispanic blacks was associated with a 7% greater risk for being in a Low-High cluster. The rate of physical inactivity and the percentage of Hispanics or non-Hispanic American Indians were associated with being in a High-Low cluster (5% to 21% greater risk).


Distinct spatial clusters of diabetes prevalence exist in the United States. Strong association between diabetes clusters and socioeconomic and other diabetes risk factors suggests that interventions might be tailored according to the prevalence of modifiable factors in specific counties.

November 26, 2012

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