Perceived risk of diabetes seriously underestimates actual diabetes risk: The KORA FF4 study

Abstract

ObjectiveEarly detection of diabetes and prediabetic states is beneficial for patients, but may be delayed by patients´ being overly optimistic about their own health. Therefore, we assessed how persons without known diabetes perceive their risk of having or developing diabetes, and we identified factors associated with perception of diabetes risk.Research design and methods1,953 participants without previously known diabetes from the population-based, German KORA FF4 Study (59.1 years, 47.8% men) had an oral glucose tolerance test. They estimated their probability of having undiagnosed diabetes mellitus (UDM) on a six category scale, and assessed whether they were at risk of developing diabetes in the future. We cross-tabulated glycemic status with risk perception, and fitted robust Poisson regression models to identify determinants of diabetes risk perception.Results74% (95% CI: 65–82) of persons with UDM believed that their probability of having undetected diabetes was low or very low. 72% (95% CI: 69–75) of persons with prediabetes believed that they were not at risk of developing diabetes. In people with prediabetes, seeing oneself at risk of diabetes was associated with self-rated poor general health (prevalence ratio (PR) = 3.1 (95% CI: 1.4–6.8), parental diabetes (PR = 2.6, 1.9–3.4), high educational level (PR = 1.9 (1.4–2.5)), lower age (PR = 0.7, 0.6–0.8, per 1 standard deviation increase), female sex (PR = 1.2, 0.9–1.5) and obesity (PR = 1.5, 1.2–2.0).ConclusionsPeople with undiagnosed diabetes or prediabetes considerably underestimate their probability of having or developing diabetes. Contrary to associations with actual diabetes risk, perceived diabetes risk was lower in men, lower educated and older persons.

Modifying effect of metabotype on diet–diabetes associations

“…All participants without previously known diabetes took part in a standard oral glucose tolerance test (OGTT) and their glucose tolerance status was classified according to the 2003 American Diabetes Association (ADA) diagnostic criteria [28]. Further details have been outlined elsewhere [29]. An OGTT value of ≥ 7.0 mmol/L fasting or ≥ 11.1 mmol/L 2-h glucose was defined as undetected diabetes mellitus (UDM), also called screen-detected diabetes.…”

What should governments be doing to prevent diabetes throughout the life course?

“…the way content is presented), targeted according to the health literacy and media use of the population, as well as visualisation or the use of narratives are evidence-based communication strategies [23]. Communication campaigns have proven effective in improving disease-specific health literacy [24], persuading high-risk populations to take part in screenings [25], increasing patients' physical activity levels [26], promoting a healthy diet [27] and improving social support for patients with diabetes [28]. When used to accompany policy initiatives, communication strategies can reduce resistance and improve overall acceptance of the initiatives [29,30].…”

Prevalence of diabetes mellitus and the associated behavioral risks factors among the staff of three secondary schools in Owo, Ondo State, Nigeria

“…A study conducted in Nigeria among university staff showed a risk perception of 67% for non-communicable diseases while good knowledge of diabetes was shown to be 30% among diabetic patients in another study (17,20). However, family members of individuals with type 2 diabetes underestimate their risk of developing the disease (21,22).…”