title: Associations between trends in race/ethnicity, aging, and body mass index with diabetes prevalence in the United States: a series of cross-sectional studies.
abstract: BACKGROUND
  The increase in the prevalence of diabetes over the past few decades has coincided with an increase in certain risk factors for diabetes, such as a changing race/ethnicity distribution, an aging population, and a rising obesity prevalence.
  
  
  OBJECTIVE
  To determine the extent to which the increase in diabetes prevalence is explained by changing distributions of race/ethnicity, age, and obesity prevalence in U.S. adults.
  
  
  METHODS
  Cross-sectional, using data from 5 NHANES (National Health and Nutrition Examination Surveys): NHANES II (1976-1980), NHANES III (1988-1994), and the continuous NHANES 1999-2002, 2003-2006, and 2007-2010.
  
  
  METHODS
  Nationally representative samples of the U.S. noninstitutionalized civilian population.
  
  
  METHODS
  23 932 participants aged 20 to 74 years.
  
  
  METHODS
  Diabetes was defined as a self-reported diagnosis or fasting plasma glucose level of 7.0 mmol/L (126 mg/dL) or more.
  
  
  RESULTS
  Between 1976 to 1980 and 2007 to 2010, diabetes prevalence increased from 4.7% to 11.2% in men and from 5.7% to 8.7% in women (P for trends for both groups < 0.001). After adjustment for age, race/ethnicity, and body mass index, diabetes prevalence increased in men (6.2% to 9.6%; P for trend < 0.001) but not women (7.6% to 7.5%; P for trend = 0.69). Body mass index was the greatest contributor among the 3 covariates to the change in prevalence estimates after adjustment.
  
  
  CONCLUSIONS
  Some possible risk factors, such as physical activity, waist circumference, and mortality, could not be studied because data on these variables were not collected in all surveys.
  
  
  CONCLUSIONS
  The increase in the prevalence of diabetes was greater in men than in women in the U.S. population between 1976 to 1980 and 2007 to 2010. After changes in age, race/ethnicity, and body mass index were controlled for, the increase in diabetes prevalence over time was approximately halved in men and diabetes prevalence was no longer increased in women.
  
  
  BACKGROUND
  Centers for Disease Control and Prevention and National Institutes of Diabetes and Digestive and Kidney Diseases.
authors.forename: Andy
authors.initials: A
authors.lastname: Menke
authors.forename: Keith F
authors.initials: KF
authors.lastname: Rust
authors.forename: Judith
authors.initials: J
authors.lastname: Fradkin
authors.forename: Yiling J
authors.initials: YJ
authors.lastname: Cheng
authors.forename: Catherine C
authors.initials: CC
authors.lastname: Cowie
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D055815:Young Adult