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

• Published in: Diabetes care Vol. 32; no. 2; pp. 287 - 294
• Main Authors: Cowie, Catherine C, Rust, Keith F, Ford, Earl S, Eberhardt, Mark S, Byrd-Holt, Danita D, Li, Chaoyang, Williams, Desmond E, Gregg, Edward W, Bainbridge, Kathleen E, Saydah, Sharon H, Geiss, Linda S
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.02.2009
• Subjects: Adolescent; Adult; Aged; Child; Dextrose; Diabetes; Diabetes Mellitus - epidemiology; Epidemiology/Health Services Research; Ethnicity - statistics & numerical data; Glucose; Glucose Tolerance Test; Glucose tolerance tests; Hemophilia; Hispanic Americans; Humans; Hyperglycemia - epidemiology; Middle Aged; Minority & ethnic groups; Mortality; Nutrition Surveys; Plasma; Prediabetic state; Prediabetic State - epidemiology; Prevalence; Risk factors; Surveys; United States - epidemiology; Womens health; Young Adult; United States
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc08-1296

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. RESEARCH DESIGN AND METHODS--In 2005-2006, the National Health and Nutrition Examination Survey included a probability sample of 7,267 people aged greater-than-or-equal12 years. Participants were classified according to glycemic status by interview for diagnosed diabetes and by fasting and 2-h glucoses measured in subsamples. RESULTS:--In 2005-2006, the crude prevalence of total diabetes in people aged greater-than-or-equal20 years was 12.9%, of which ~40% was undiagnosed. In people aged greater-than-or-equal20 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 non-Hispanic whites, age- and sex-standardized prevalence of diagnosed diabetes was approximately twice as high in non-Hispanic blacks (P < 0.0001) and Mexican Americans (P = 0.0001), whereas undiagnosed diabetes was not higher. Crude prevalence of diagnosed diabetes in people aged greater-than-or-equal20 years rose from 5.1% in 1988-1994 to 7.7% in 2005-2006 (P = 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. CONCLUSIONS:--Over 40% of people aged greater-than-or-equal20 years have hyperglycemic conditions, and prevalence is higher in minorities. Diagnosed diabetes has increased over time, but other conditions have been relatively stable.