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. 2018 Jan 12;6(1):e000487.
doi: 10.1136/bmjdrc-2017-000487. eCollection 2018.

Trends in type 2 diabetes detection among adults in the USA, 1999-2014

Linda S Geiss  1 , Kai McKeever Bullard  1 , Ralph Brinks  2 , Annika Hoyer  2 , Edward W Gregg  1
Affiliations

Trends in type 2 diabetes detection among adults in the USA, 1999-2014

Linda S Geiss et al. BMJ Open Diabetes Res Care. .

Abstract

Objective: To examine recent trends in type 2 diabetes detection among adults in the USA.

Research design and methods: We used data from the 1999-2014 National Health and Nutrition Examination Surveys on non-pregnant adults (aged ≥18 years) not reporting a diagnosis of diabetes (n=16 644 participants, averaging about 2000 for each 2-year cycle). We defined undiagnosed diabetes as a fasting plasma glucose ≥126 mg/dL or a hemoglobin A1c ≥6.5% (48 mmol/mol). We measured case detection as the probability of finding undiagnosed type 2 diabetes among the population without diagnosed diabetes. Linear regression models were used to examine trends overall and by sociodemographic characteristics (ie, age, gender, race/ethnicity, education, poverty-income ratio (PIR)).

Results: Age-standardized probability of finding undiagnosed type 2 diabetes was 3.0% (95% CI 2.1% to 4.2%) during 1999-2000 and 2.8% (2.2%-3.6%) during 2013-2014 (P for trend=0.52). Probability increased among Mexican-Americans (P for trend=0.01) but decreased among adults aged 65 years or older (P for trend=0.04), non-Hispanic (NH) white (P for trend=0.02), and adults in the highest PIR tertile (P for trend=0.047). For all other sociodemographic groups, no significant trends were detected.

Conclusions: We found little evidence of increased detection of undiagnosed type 2 diabetes among adults in the USA during the past 15 years. Although improvements were seen among NH white, older, and wealthy adults, these improvements were not large. As the scope of primary prevention efforts increases, case detection may improve.

Keywords: diagnosis; epidemiology; survey research; type 2 diabetes.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Age-standardized probability of finding undiagnosed diabetes among the US population without diagnosed diabetes aged ≥18 years by survey cycle. National Health and Nutrition Examination Surveys 1999–2014. P for trend=0.52, calculated from a linear regression model by using variance weighted least squares with 2-year survey cycle as the independent variable.
See this image and copyright information in PMC

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