Full accounting of diabetes and pre-diabetes in the U.S. population in 1988-1994 and 2005-2006.
OBJECTIVE
We examined the prevalences of diagnosed diabetes, and undiagnosed diabetes and pre-diabetes using fasting and 2-h oral glucose tolerance test values, in the U.S. during 2005-2006. We then compared the prevalences of these conditions with those in 1988-1994.


METHODS
In 2005-2006, the National Health and Nutrition Examination Survey included a probability sample of 7,267 people aged > or =12 years. Participants were classified according to glycemic status by interview for diagnosed diabetes and by fasting and 2-h glucoses measured in subsamples.


RESULTS
In 2005-2006, the crude prevalence of total diabetes in people aged > or =20 years was 12.9%, of which approximately 40% was undiagnosed. In people aged > or =20 years, the crude prevalence of impaired fasting glucose was 25.7% and of impaired glucose tolerance was 13.8%, with almost 30% having either. Over 40% of individuals had diabetes or pre-diabetes. Almost one-third of the elderly had diabetes, and three-quarters had diabetes or pre-diabetes. Compared with non-Hispanic whites, age- and sex-standardized prevalence of diagnosed diabetes was approximately twice as high in non-Hispanic blacks (P < 0.0001) and Mexican Americans (P = 0.0001), whereas undiagnosed diabetes was not higher. Crude prevalence of diagnosed diabetes in people aged > or =20 years rose from 5.1% in 1988-1994 to 7.7% in 2005-2006 (P = 0.0001); this was significant after accounting for differences in age and sex, particularly in non-Hispanic blacks. Prevalences of undiagnosed diabetes and pre-diabetes were generally stable, although the proportion of total diabetes that was undiagnosed decreased in Mexican Americans.


CONCLUSIONS
Over 40% of people aged > or =20 years have hyperglycemic conditions, and prevalence is higher in minorities. Diagnosed diabetes has increased over time, but other conditions have been relatively stable.
Cowie
Catherine C
CC
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA. cowiec@mail.nih.gov
Rust
Keith F
KF
Ford
Earl S
ES
Eberhardt
Mark S
MS
Byrd-Holt
Danita D
DD
Li
Chaoyang
C
Williams
Desmond E
DE
Gregg
Edward W
EW
Bainbridge
Kathleen E
KE
Saydah
Sharon H
SH
Geiss
Linda S
LS
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005006:Ethnicity / Q000706:statistics & numerical data; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D008875:Middle Aged; D009749:Nutrition Surveys; D011236:Prediabetic State / Q000453:epidemiology*; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D055815:Young Adult