NHANES: Nearly 25% of U.S. veterans have diabetes
More than 20% of U.S. veterans have diabetes and 3.4% have undiagnosed diabetes, a combined figure that is more than double the diabetes rate in the overall U.S. population, according to findings published in Preventing Chronic Disease.
In an analysis of five cycles of U.S. National Health and Nutrition Examination Survey data conducted between 2005 and 2014, researchers also found that diabetes was most prevalent among veterans aged at least 65 years (27%), male veterans (22%) and veterans with less than 12 years of education (33.5%). Hispanic veterans had the highest prevalence of both diabetes (25.7%) and obesity (43.5%).
“The available evidence strongly suggests that problems faced by U.S. veterans in this area are severe,” Ying Liu, PhD, assistant professor in the department of biostatistics and epidemiology at East Tennessee State University College of Public Health, told Endocrine Today. “Based on the National Health and Nutrition Examination Survey, diabetes in U.S. veterans was very prevalent. Disparities of diabetes also existed in U.S. veterans.”
In the analysis, the unweighted sample size for 2013-2014 was 491; sample sizes ranged from 472 to 685 for each cycle between 2005 and 2012. Diabetes was defined as HbA1c at least 6.5%, fasting plasma glucose at least 126 mg/dL, 2-hour plasma glucose at least 200 mg/dL or a diagnosis of diabetes.
Researchers also found that the overall prevalence trend of diabetes increased from 15.5% in 2005-2006 to 20.5% in 2013-2014 (P = .04 for trend), and peaked in 2009-2010 at 22.6%. Both poverty level (P = .005) and education (P = .03) were associated with the odds of having diabetes.
“Unlike previously reported findings, our findings showed that the prevalence of diabetes by poverty level did not decline with increasing income, and this trend persisted over time,” the researchers wrote. “This persistence may be due to a small number of diabetes cases and some unidentified confounders.”
The researchers noted that NHANES data can serve as a more appropriate resource vs. VA data when analyzing the rate of diabetes among veterans; in fiscal year 2014, more than 70% of veterans sought care outside the VA system despite being enrolled. Future investigations, the researchers wrote, should combine the nationwide data with VA data to obtain estimates that are more accurate.
“Cost-effective prevention and intervention approaches are needed for U.S. veterans to lower the diabetes prevalence and ultimately improve their general health and life of quality,” Liu said. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.