RT Journal Article
SR Electronic
T1 Trends in type 2 diabetes detection among adults in the USA, 1999–2014
JF BMJ Open Diabetes Research & Care
JO BMJ Open Diab Res Care
FD American Diabetes Association
SP e000487
DO 10.1136/bmjdrc-2017-000487
VO 6
IS 1
A1 Linda S Geiss
A1 Kai McKeever Bullard
A1 Ralph Brinks
A1 Annika Hoyer
A1 Edward W Gregg
YR 2018
UL http://drc.bmj.com/content/6/1/e000487.abstract
AB 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.