Prevalence of Diabetes and Impaired Fasting Glucose in Adults in the U.S. Population: National Health and Nutrition Examination Survey 1999-2002

C. C. Cowie, K. F. Rust, D. D. Byrd-Holt, M. S. Eberhardt, K. M. Flegal, M. M. Engelgau, S. H. Saydah, D. E. Williams, L. S. Geiss, E. W. Gregg
2006 Diabetes Care  
OBJECTIVE -The purpose of this study was to examine the prevalences of diagnosed and undiagnosed diabetes, and impaired fasting glucose (IFG) in U. S. adults during 1999 -2002, and compare prevalences to those in 1988 -1994. RESEARCH DESIGN AND METHODS -The National Health and Nutrition Examination Survey (NHANES) contains a probability sample of adults aged Ն20 years. In the NHANES 1999NHANES -2002,761 adults were classified on glycemic status using standard criteria, based on an interview for
more » ... diagnosed diabetes and fasting plasma glucose measured in a subsample. RESULTS -The crude prevalence of total diabetes in 1999 -2002 was 9.3% (19.3 million, 2002 U.S. population), consisting of 6.5% diagnosed and 2.8% undiagnosed. An additional 26.0% had IFG, totaling 35.3% (73.3 million) with either diabetes or IFG. The prevalence of total diabetes rose with age, reaching 21.6% for those aged Ն65 years. The prevalence of diagnosed diabetes was twice as high in non-Hispanic blacks and Mexican Americans compared with non-Hispanic whites (both P Ͻ 0.00001), whereas the prevalence of undiagnosed diabetes was similar by race/ethnicity, adjusted for age and sex. The prevalence of diagnosed diabetes was similar by sex, but prevalences of undiagnosed diabetes and IFG were significantly higher in men. The crude prevalence of diagnosed diabetes rose significantly from 5.1% in 1988 -1994 to 6.5% in 1999 -2002, but the crude prevalences were stable for undiagnosed diabetes (from 2.7 to 2.8%) and IFG (from 24.7 to 26.0%). Results were similar after adjustment for age and sex. CONCLUSIONS -Although the prevalence of diagnosed diabetes has increased significantly over the last decade, the prevalences of undiagnosed diabetes and IFG have remained relatively stable. Minority groups remain disproportionately affected. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Data are % (95% CI). Undiagnosed diabetes is defined as fasting plasma glucose Ն7.0 mmol/l. Values for the total population and for men and women include those of race/ethnic groups not listed separately. All CIs were logit transformed. *Standardized to the 2000 U.S. Census population by age and sex for the total population and race/ethnic groups and by age for sex-groups. †In the age 20-to 39-year group, there was no undiagnosed diabetes among 256 non-Hispanic white men and 400 Mexican Americans (186 men and 214 women) who were in the nondiabetic fasting morning sample.
doi:10.2337/dc06-0062 pmid:16732006 fatcat:eaie5bb46jdahnxwp3n27boide