title: Awareness, treatment, and control of LDL cholesterol are lower among U.S. adults with undiagnosed diabetes versus diagnosed diabetes.
abstract: OBJECTIVE
  Diabetes is often undiagnosed, resulting in incorrect risk stratification for lipid-lowering therapy. We conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) 2005-2010 to determine the prevalence, awareness, treatment, and control of elevated LDL cholesterol (LDL-C) among U.S. adults with undiagnosed diabetes.
  
  
  METHODS
  Fasting NHANES participants 20 years of age or older who had 10-year Framingham coronary heart disease (CHD) risk scores <20% and were free of CHD or other CHD risk equivalents (n = 5,528) were categorized as having normal glucose, impaired fasting glucose, undiagnosed diabetes, or diagnosed diabetes. High LDL-C was defined by the 2004 Adult Treatment Panel (ATP) III guidelines.
  
  
  RESULTS
  The prevalence of diagnosed and of undiagnosed diabetes was 8 and 4%, respectively. Mean LDL-C was 102 ± 2 mg/dL among those with diagnosed diabetes and 117 ± 3 mg/dL for those with undiagnosed diabetes (P < 0.001). The prevalence of high LDL-C was similar among individuals with undiagnosed (81%) and diagnosed (77%) diabetes. Among individuals with undiagnosed diabetes and high LDL-C, 38% were aware, 27% were treated, and 16% met the ATP III LDL-C goal for diabetes. In contrast, among individuals with diagnosed diabetes and high LDL-C, 70% were aware, 61% were treated, and 36% met the ATP III goal. Subjects with undiagnosed diabetes remained less likely to have controlled LDL-C after multivariable adjustment (prevalence ratio, 0.42; 95% CI, 0.23-0.80).
  
  
  CONCLUSIONS
  Improved screening for diabetes and reducing the prevalence of undiagnosed diabetes may identify individuals requiring more intensive LDL-C reduction.
authors: Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. tmbrown@uab.edu
authors: Todd M
authors: TM
authors: Brown
authors: Rikki M
authors: RM
authors: Tanner
authors: April P
authors: AP
authors: Carson
authors: Huifeng
authors: H
authors: Yun
authors: Robert S
authors: RS
authors: Rosenson
authors: Michael E
authors: ME
authors: Farkouh
authors: J Michael
authors: JM
authors: Woolley
authors: Evan L
authors: EL
authors: Thacker
authors: Stephen P
authors: SP
authors: Glasser
authors: Monika M
authors: MM
authors: Safford
authors: Paul
authors: P
authors: Muntner
mesh_terms: D000328:Adult; D000368:Aged; D008078:Cholesterol, LDL / Q000097:blood*; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D008078:Cholesterol, LDL
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