Perspective from
September 22, 2018
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CDC: 14% of US adults have diabetes, many unaware of disease status

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The prevalence of diabetes among adults in the United States rose to 14% between 2013 and 2016, with nearly 31% of those with diabetes unaware they have the disease, according to a new report from the CDC’s National Center for Health Statistics.

The report, which presents findings from the National Health and Nutrition Examination Survey, a cross-sectional sample of U.S. adults, also notes that the prevalence of total, diagnosed and undiagnosed diabetes was higher among Hispanic vs. white adults, whereas the prevalence of total and diagnosed diabetes was higher among black vs. white adults.

“Type 2 diabetes can progress over an extended time period with gradual, often unnoticed changes occurring before diagnosis,” Nicholas D. Mendola, MPH, a student volunteer with the National Center for Health Statistics (NCHS), and colleagues wrote in the NCHS Data Brief. “If left unmanaged, diabetes may contribute to serious health outcomes, including neuropathy, nephropathy, retinopathy, coronary artery disease, stroke and peripheral vascular disease.”

For the survey, participants were classified as having diagnosed diabetes if they responded “yes” to a question on whether they had the disease at any time other than pregnancy. Undiagnosed diabetes was defined as a fasting plasma glucose measurement of at least 126 mg/dL or an HbA1c of at least 6.5% in an adult who did not report a diagnosis of diabetes by a health care provider. Total diabetes was defined as the combined, overall prevalence of diagnosed and undiagnosed diabetes.

The latest data show that the prevalence of total diabetes was higher among men vs. women (10.8% vs. 8.8%) and increased with age. Prevalence of total diabetes ranged from 3.5% among adults aged 20 to 39 years to 28.2% among adults aged at least 60 years. Additionally, total diabetes prevalence was higher among all minority groups; prevalence was highest among Hispanic adults (19.8%), followed by black adults (17.9%) and Asian adults (15.3%) vs. white adults (12.4%)

Researchers also found that total diabetes prevalence increased with increasing weight status category, from 6.2% among adults with underweight or normal weight, to 11.8% among adults with overweight to 20.7% among adults with obesity. Similarly, the prevalence of undiagnosed diabetes increased with increasing weight category, from 3.2% among adults with overweight to 6.8% among adults with obesity.

The NHANES consists of interviews conducted in participants’ homes, standardized exams in mobile centers and laboratory blood tests. Criteria from the American Diabetes Association were used to define diabetes. For the 2013-2016 survey, Hispanic, black and Asian adults were oversampled to obtain reliable estimates, according to researchers.

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“Continued monitoring of total, diagnosed and undiagnosed diabetes will provide information about the burden of diabetes among adults in the United States,” the researchers wrote. – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.