Full Accounting of Diabetes and Pre-Diabetes in the U.S. Population in 1988–1994 and 2005–2006

Abstract

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.

Recent population changes in HbA1c and fasting insulin concentrations among US adults with preserved glucose homeostasis

“…Between 1988 and 1994, and 1999 and 2006, mean FPG levels changed very little, perhaps reflecting the robust compensatory mechanisms at work in the majority of people without diabetes. These mechanisms may also explain why the prevalence of type 2 diabetes is increasing in the US population, while the prevalence of prediabetes has been stable [2].…”

“…While concentrations of fasting insulin have increased among non-diabetic US adults [1], a corresponding increase in the prevalence of prediabetes has not been found [2]. The lack of increase in the prevalence of prediabetes may be because normal levels of fasting plasma glucose (FPG) are preserved in persons without diabetes by homeostatic mechanisms (e.g.…”

Preoperative “NPO” as an opportunity for diabetes screening

“…National Health and Nutrition Examination Survey (NHANES) data documented the ambulatory prevalence of diabetes mellitus (DM) in adults 20 years of age in the United States to be 12.9%. 6 However, the most significant health crisis may be that 40% of these adult patients with diabetes are unaware of their diagnosis. 6 In other words, 5.1% of all adults 20 years of age or older in this country have undiagnosed diabetes.…”

Men and women respond differently to rapid weight loss: Metabolic outcomes of a multi‐centre intervention study after a low‐energy diet in 2500 overweight, individuals with pre‐diabetes (PREVIEW)

“…The prevalence of pre‐diabetes has been reported to be significantly higher in men than in women 18. Impaired fasting glucose (IFG), which is indicative of hepatic insulin resistance (IR), is also more common in men, typically 1.5‐3 times higher 19.…”