States with the Most Diabetes

About 1 in 5 adults in West Virginia (18.4%) have been told by a doctor they have diabetes — the highest rate of any state, and roughly 2.2 times the 8.4% in Colorado, which ranks last. What makes this map stand out from some of our others is how *clean* the geography is. There's almost no scatter at the top: the seven highest-ranked states are all next to each other.

The top of this list reads like a map of Appalachia and the Deep South. West Virginia leads, followed by Kentucky (16.2%), Louisiana (15.4%), Arkansas (15.3%), Mississippi (15.2%), Alabama (15.1%), and Tennessee (14.5%) — a single, unbroken band stretching from the mountains down to the Gulf. The bottom of the list flips to the Mountain West, where Utah (8.7%) and Colorado (8.4%) sit at #49 and #50. That kind of tidy regional sorting — one cluster clearly high, another clearly low — is a sign the underlying pattern is real and not just survey noise.

The cleanest way to read this map is alongside our obesity ranking, because the two line up almost exactly at the extremes. West Virginia is also #1 for obesity (41.4%), and Colorado is also #50 for obesity (25.0%) — the same two states bookending both lists. Type 2 diabetes is closely tied to weight, diet, and activity, so it isn't surprising that the heaviest-burden states for one tend to be the heaviest for the other. The link is a well-established association, not something this single survey can prove on its own, but seeing the identical #1 and #50 states on both maps is about as strong a hint as a 50-state ranking can give.

One nuance worth keeping in mind: this measures diagnosed diabetes — adults who say a doctor *told them* they have it. That means it can miss people who have the disease but have never been tested, and it lumps together type 1 and type 2 rather than separating them. So a state's rank reflects both how common diabetes truly is and how often it gets caught and recorded. West Virginia isn't an outlier only here, either: in our other CDC maps it also ranks #1 for adult smoking (20.8%), #1 for arthritis (41.2%), and #1 for the worst self-rated health (26.3%) — the same handful of Appalachian states keep surfacing at the top of one health ranking after another.

A note on method: every figure here comes from the same CDC survey (BRFSS), the same year, and the same definition, so the 50-state comparison is apples-to-apples. The one exception is Tennessee, shown with its 2023 value (period 2023), because CDC had not released a 2024 figure for it; it's flagged per-row rather than silently mixed in. The numbers are CDC's; the ranking and analysis are ours.