Decrease in undiagnosed diabetes cases suggests improvements in screening, diagnosis

Although prevalence of total diabetes increased substantially during the last 2 decades, the proportion of undiagnosed diabetes cases decreased, suggesting improvements in screening and diagnosis, according to study results published in the Annals of Internal Medicine.

Researchers used calibrated HbA1c levels from the National Health and Nutrition Examination Survey in 1988-1994 and 1999-2010 to define undiagnosed diabetes, prediabetes and glycemic control among patients with diagnosed diabetes. Trends in HbA1c categories were compared with fasting glucose levels.

Study results showed approximately 21 million US adults aged 20 years or older had total confirmed diabetes in 2010. While the prevalence of total confirmed diabetes increased during 2 decades, researchers found the prevalence of undiagnosed diabetes remained stable, reducing the proportion of total undiagnosed diabetes cases to 11% in 2005-2010. When defined by calibrated HbA1c levels, the prevalence of prediabetes was lower vs. when defined by fasting glucose levels. However, when defined solely by HbA1c levels, the prevalence of prediabetes increased from 5.8% in 1988-1994 to 12.4% in 2005-2010, according to study results. Overall, glycemic control improved, but researchers found an increase in total diabetes prevalence and less control of diabetes among non-Hispanic blacks and Mexican Americans vs. non-Hispanic whites.

For more information:

Selvin E. Ann Intern Med. 2014;doi:10.7326/M13-2411.

Disclosure: The researchers have no relevant financial disclosures.


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