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Defeat Diabetes Foundation

Defeat Diabetes
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One-Third of Adults With Diabetes Still Don't Know They Have It

Posted: Friday, June 02, 2006

The prevalence of diagnosed diabetes in U.S. adults age 20 and older has risen from about 5.1% to 6.5%, according to researchers at the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC).

However, the percentage of adults with undiagnosed diabetes did not change significantly over the years studied. About 2.8% of U.S. adult -- one-third of those with diabetes -- still don't know they have it. The study, published in the June 2006 issue of Diabetes Care, notes that type 2 diabetes accounts for up to 95% of all diabetes cases and virtually all undiagnosed diabetes cases.

Over the years studied, about 26% of adults age 20 and older continued to have impaired fasting glucose (IFG), a form of pre-diabetes. IFG, in which blood glucose measured after an overnight fast is high but not yet diagnostic of diabetes, increases the risk of heart disease as well as the risk of developing type 2 diabetes.

The researchers also found that:

nearly 22% of people age 65 and older had diabetes.

about 13% of non-Hispanic blacks age 20 and older had diabetes. Diabetes was twice as common in non-Hispanic blacks compared to non-Hispanic whites.

about 8% of Mexican Americans age 20 and older had diabetes. Because the average age of Mexican Americans is younger than for other groups, the age-and sex-adjusted prevalence of diabetes in Mexican Americans is twice that of non-Hispanic whites and about equal to that of non-Hispanic blacks.

IFG and undiagnosed diabetes were about 70% more common in men than in women, especially in non-Hispanic white men.

nearly 40% of people age 65 and older had IFG, which becomes more common with age.

In the study, the researchers compared two slices of data, one from 1988 to 1994 and the other from 1999 to 2002. The data were derived from a national sample of U.S. adults age 20 years and older who took part in the National Health and Nutrition Examination Survey (NHANES) conducted by the CDC's National Center for Health Statistics. Survey participants were interviewed in their homes and received a physical exam with a blood test, which included a glucose reading taken after an overnight fast. The NHANES is unique because it includes a blood test that detects undiagnosed diabetes and IFG.

"This study updates and generally corroborates earlier analyses that were based on 2 years of NHANES data," said lead author Catherine Cowie, Ph.D., of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). "We're seeing a rising prevalence of diagnosed diabetes that is not substantially offset by a drop in the rate of undiagnosed--about one-third of adults with diabetes still don't know they have it. Another 26% of adults have a form of pre-diabetes."

Pre-diabetes, which usually causes no symptoms, is serious because many people with the condition develop type 2 diabetes in the next 10 years. Also, pre-diabetes substantially raises the risk of a heart attack or stroke even if type 2 diabetes does not develop. People with pre-diabetes may have IFG or impaired glucose tolerance (IGT) or both.

If you are over age 45, you should consult your health care provider about testing for pre-diabetes or diabetes. If you are younger than 45, overweight, and have another risk factor, you should ask about testing. You are at greater risk of developing pre-diabetes and type 2 diabetes if you:

are age 45 or older
have a family history of diabetes
are overweight
have an inactive lifestyle (exercise less than three times a week)
are members of a high-risk ethnic population (e.g., African American, Hispanic/Latino American, American Indian and Alaska Native, Asian American, Pacific Islander)
have high blood pressure: 140/90 mm/Hg or higher
have an HDL cholesterol less than 35 mg/dL or a triglyceride level 250 mg/dL or higher
have had diabetes that developed during pregnancy (gestational diabetes) or have given birth to a baby weighing more than 9 pounds
have polycystic ovary syndrome, a metabolic disorder that affects the female reproductive system
have acanthosis nigricans (dark, thickened skin around neck or armpits)
have a history of disease of the blood vessels to the heart, brain, or legs
have had IFG or IGT on previous testing.