Diabetes prevalence, awareness, and control in the United States, 2017-2023

Abstract

Introduction: We compared diabetes prevalence, awareness, and control pre versus post the Covid-19 pandemic.

Methods: This was a cross-sectional analysis of the U.S. National Health and Nutrition Examination Surveys pre (2017-2020) and post (2021-2023) the pandemic. We included all non-pregnant adults (aged ≥ 20 years) who had undergone biomedical testing. Diagnosed and undiagnosed diabetes was defined as self-reported diabetes and no self-reported diabetes with HbA1c >6.5 % or fasting plasma glucose ≥126 mg/dL, respectively. Among diagnosed diabetes, we estimated proportions achieving glycemic (HbA1c < 7.0 %), blood pressure (< 130/80 mmHg), and cholesterol control (non-high-density lipoprotein < 130mg/dl), and use of blood pressure and lipid lowering medications.

Results: The prevalence of total diabetes, diagnosed diabetes, undiagnosed diabetes, and proportion of diabetes that was undiagnosed remained stable between pre and post pandemic periods: from 16.2 % [95 %CI: 14.3-18.1] to 15.8 % [13.7-17.9], from 11.7 % [10.1-13.2] to 11.3 % [9.4-13.2], from 4.6 % [3.8-5.3]) to 4.5 % [3.4-5.6]), and from 28.1 % [24.3-31.8] to 28.4 % [21.9-35.0], respectively. Among those with diagnosed diabetes, glycemia, blood pressure, lipid control, and use of blood pressure or lipid medication did not significantly change.

Conclusions: Between 2017-2020 and 2021-2023, there were no significant changes in diabetes prevalence, awareness, and control in the U.S.

Keywords: Covid-19; Diabetes; Diabetes care; Epidemiology; Undiagnosed diabetes.