It’s time to stop offering pastries and sugary soft drinks in client meetings.

According to the Centers for Disease Control and Prevention (CDC), 12.6% of U.S. adults age 20 and older have diabetes, and about one-quarter of the members of that group are unaware they have the condition. The numbers are much worse for older Americans. The American Diabetes Association (ADA) estimates that almost 26% of those age 65 and older are diabetic.

(Related: 10 Towns Where a LOT of People Got Fat)

These findings are part of the CDC’s Behavioral Risk Factor Surveillance System (BRFSS) Prevalence Data, for the period from 2011 to the present. The survey database shows a wide disparity in diabetes prevalence rates across the country. Puerto Rico has the dubious distinction of leading the list, with 16.5% of respondents having diabetes, while Colorado can claim the lowest rate, with a prevalence rate of just 6.8%.

Higher diabetes rates translate into higher health problem rates. Diabetes diagnoses are linked to hypoglycemia, high blood pressure and increased risk for heart attacks, strokes and kidney disease. Diabetes is the seventh-leading cause of death in America. It was responsible for over 76,000 deaths in 2014. The situation isn’t improving: The ADA reports 1.4 million new cases are diagnosed each year.

Higher diabetes rates also translate into higher rates of insurability problems.

Individuals with Type 1 and 2 diabetes are already facing an uphill battle in terms of receiving favorable offers from underwriters, Matthew Schmidt, a diabetes life insurance advisor with Diabetes Life Solutions in Pittsburgh, says via email.

Client with an advisor (Photo: Thinkstock)

(Photo: Thinkstock)

Schmidt cites the example of a 40-year-old male who was diagnosed with type 1 diabetes at age 16. That person would not receive a standard, non-tobacco use rating from a life insurer, no matter how much control he has over his diabetes.

Schmidt cautions that each insurance company has its own underwriting guidelines, so agents need to know which companies to approach under different circumstances. However, he adds, there are some steps all people with diabetes can take to can improve their offers of coverage, including:

  • Stop smoking. Being tobacco-free for at least a year lets people with diabetes qualify for non-tobacco user ratings.
  • Use diabetes technology. Certain insurance companies may offer a healthy lifestyle credit if applicants use technologies like insulin pumps and continuous glucose monitoring (CGM) systems.
  • Diet and exercise. Applicants with good overall health as a result of healthy diet and regular exercise receive more favorable coverage offers.
  • Work on controlling your diabetes. If applicants aren’t seeing doctors at least annually, insurers might view that as neglecting diabetes management. This could lead to a more expensive coverage offer or postponement of an offer.

For a look at the five states with the highest reported diabetes rates, and a chart showing the rates for all jurisdictions, read on.

 Mississippi highway sign (Photo: Shutterstock)

(Photo: Shutterstock)

The States With the Highest Reported Diabetes Rates

1. Mississippi: 14.7%

2. West Virginia: 14.5%

3. Alabama: 13.5%

4. Kentucky: 13.4%

6. Tennessee: 12.7%

Reported Diabetes Rates for All 50 States,  the District of Columbia and U.S. Territories (in percent)

Alabama 13.5
Alaska 7.6
All States and DC (median) 9.9
Arizona 10.1
Arkansas 12.6
California 10
Colorado 6.8
Connecticut 9.3
Delaware 11.5
District of Columbia 8.5
Florida 11.3
Georgia 11.3
Guam 12
Hawaii 8.5
Idaho 8.1
Illinois 9.9
Indiana 11.4
Iowa 8.8
Kansas 9.7
Kentucky 13.4
Louisiana 12.7
Maine 9.9
Maryland 10.3
Massachusetts 8.9
Michigan 10.7
Minnesota 7.6
Mississippi 14.7
Missouri 11.5
Montana 7.9
Nebraska 8.8
Nevada 9.7
New Hampshire 8.1
New Jersey 9
New Mexico 11.5
New York 9.8
North Carolina 10.7
North Dakota 8.7
Ohio 11
Oklahoma 11.7
Oregon 10.7
Pennsylvania 10.4
Puerto Rico 16.5
Rhode Island 9
South Carolina 11.8
South Dakota 9.3
Tennessee 12.7
Texas 11.4
Utah 7
Vermont 8.2
Virginia 10.4
Washington 8.4
West Virginia 14.5
Wisconsin 8.4
Wyoming 8.4
Source: CDC/BRFSS

 — Check out 10 Towns Where People Should Exercise More on ThinkAdvisor.