OBJECTIVE -The purpose of this study was to examine the prevalences of diagnosed and undiagnosed diabetes, and impaired fasting glucose (IFG) in U.S. adults during 1999 -2002, and compare prevalences to those in 1988 -1994. RESEARCH DESIGN AND METHODS -The National Health and Nutrition Examination Survey (NHANES) contains a probability sample of adults aged Ն20 years. In the NHANES 1999NHANES -2002,761 adults were classified on glycemic status using standard criteria, based on an interview for diagnosed diabetes and fasting plasma glucose measured in a subsample.RESULTS -The crude prevalence of total diabetes in 1999 -2002 was 9.3% (19.3 million, 2002 U.S. population), consisting of 6.5% diagnosed and 2.8% undiagnosed. An additional 26.0% had IFG, totaling 35.3% (73.3 million) with either diabetes or IFG. The prevalence of total diabetes rose with age, reaching 21.6% for those aged Ն65 years. The prevalence of diagnosed diabetes was twice as high in non-Hispanic blacks and Mexican Americans compared with non-Hispanic whites (both P Ͻ 0.00001), whereas the prevalence of undiagnosed diabetes was similar by race/ethnicity, adjusted for age and sex. The prevalence of diagnosed diabetes was similar by sex, but prevalences of undiagnosed diabetes and IFG were significantly higher in men. The crude prevalence of diagnosed diabetes rose significantly from 5.1% in 1988 -1994 to 6.5% in 1999 -2002, but the crude prevalences were stable for undiagnosed diabetes (from 2.7 to 2.8%) and IFG (from 24.7 to 26.0%). Results were similar after adjustment for age and sex.CONCLUSIONS -Although the prevalence of diagnosed diabetes has increased significantly over the last decade, the prevalences of undiagnosed diabetes and IFG have remained relatively stable. Minority groups remain disproportionately affected. Diabetes Care 29:1263-1268, 2006D iabetes and its complications are major causes of morbidity and mortality in the U.S. (1). The economic cost of diabetes in medical expenditures and lost productivity was estimated to be $132 billion in the U.S. in 2002 (2). Nationally the prevalence of self-reported diagnosed diabetes has steadily increased over time (3), but the extent to which this increase is due to enhanced detection is uncertain. Undiagnosed diabetes and impaired fasting glucose (IFG) also have important health consequences (4,5). Only one nationally representative survey, The National Health and Nutrition Examination Survey (NHANES), examines both diagnosed diabetes and undiagnosed diabetes. This survey showed that from 1988 to 1994, undiagnosed diabetes comprised approximately one-third of total diabetes (diagnosed and undiagnosed) in U.S. adults (6). The prevalence of IFG was nearly as high as the prevalence of total diabetes. In 1999, the NHANES became a continuous annual survey with data released every 2 years, and we reported the prevalence of diagnosed diabetes, undiagnosed diabetes, and IFG in adults based on data from 1999 to 2000 (7). The limited sample size in these 2 years, however, restricted the detail a...

OBJECTIVE -We examined the prevalences of diagnosed diabetes, and undiagnosed diabetes and pre-diabetes using fasting and 2-h oral glucose tolerance test values, in the U.S. during [2005][2006]. We then compared the prevalences of these conditions with those in 1988 -1994. , the National Health and Nutrition Examination Survey included a probability sample of 7,267 people aged Ն12 years. Participants were classified according to glycemic status by interview for diagnosed diabetes and by fasting and 2-h glucoses measured in subsamples. , the crude prevalence of total diabetes in people aged Ն20 years was 12.9%, of which ϳ40% was undiagnosed. In people aged Ն20 years, the crude prevalence of impaired fasting glucose was 25.7% and of impaired glucose tolerance was 13.8%, with almost 30% having either. Over 40% of individuals had diabetes or pre-diabetes. Almost one-third of the elderly had diabetes, and three-quarters had diabetes or pre-diabetes. Compared with nonHispanic whites, age-and sex-standardized prevalence of diagnosed diabetes was approximately twice as high in non-Hispanic blacks (P Ͻ 0.0001) and Mexican Americans (P ϭ 0.0001), whereas undiagnosed diabetes was not higher. Crude prevalence of diagnosed diabetes in people aged Ն20 years rose from 5.1% in 1988 -1994 to 7.7% in 2005-2006 (P ϭ 0.0001); this was significant after accounting for differences in age and sex, particularly in non-Hispanic blacks. Prevalences of undiagnosed diabetes and pre-diabetes were generally stable, although the proportion of total diabetes that was undiagnosed decreased in Mexican Americans. RESEARCH DESIGN AND METHODS RESULTSCONCLUSIONS -Over 40% of people aged Ն20 years have hyperglycemic conditions, and prevalence is higher in minorities. Diagnosed diabetes has increased over time, but other conditions have been relatively stable.

OBJECTIVETo determine the prevalence of people with diabetes who meet hemoglobin A1c (A1C), blood pressure (BP), and LDL cholesterol (ABC) recommendations and their current statin use, factors associated with goal achievement, and changes in the proportion achieving goals between 1988 and 2010.RESEARCH DESIGN AND METHODSData were cross-sectional from the National Health and Nutrition Examination Surveys (NHANES) from 1988–1994, 1999–2002, 2003–2006, and 2007–2010. Participants were 4,926 adults aged ≥20 years who self-reported a previous diagnosis of diabetes and completed the household interview and physical examination (n = 1,558 for valid LDL levels). Main outcome measures were A1C, BP, and LDL cholesterol, in accordance with the American Diabetes Association recommendations, and current use of statins.RESULTSIn 2007–2010, 52.5% of people with diabetes achieved A1C <7.0% (<53 mmol/mol), 51.1% achieved BP <130/80 mmHg, 56.2% achieved LDL <100 mg/dL, and 18.8% achieved all three ABCs. These levels of control were significant improvements from 1988 to 1994 (all P < 0.05). Statin use significantly increased between 1988–1994 (4.2%) and 2007–2010 (51.4%, P < 0.01). Compared with non-Hispanic whites, Mexican Americans were less likely to meet A1C and LDL goals (P < 0.03), and non-Hispanic blacks were less likely to meet BP and LDL goals (P < 0.02). Compared with non-Hispanic blacks, Mexican Americans were less likely to meet A1C goals (P < 0.01). Younger individuals were less likely to meet A1C and LDL goals.CONCLUSIONSDespite significant improvement during the past decade, achieving the ABC goals remains suboptimal among adults with diabetes, particularly in some minority groups. Substantial opportunity exists to further improve diabetes control and, thus, to reduce diabetes-related morbidity and mortality.