Article

Type 2 Diabetes in Older Well-Functioning People: Who Is Undiagnosed?: Data from the Health, Aging, and Body Composition Study

University of Florence, Florens, Tuscany, Italy
Diabetes Care (Impact Factor: 8.57). 12/2001; 24(12):2065-70. DOI: 10.2337/diacare.24.12.2065
Source: PubMed

ABSTRACT To assess, in an older population, the prevalence of diagnosed and undiagnosed diabetes, the number needed to screen (NNTS) to identify one individual with undiagnosed diabetes, and factors associated with undiagnosed diabetes.
Socioeconomic and health-related factors were assessed at the baseline examination of the Health, Aging, and Body Composition (Health ABC) Study, a cohort of 3,075 well-functioning people aged 70-79 years living in Memphis, Tennessee and Pittsburgh, Pennsylvania (42% blacks and 48% men). Diabetes was defined according to the 1985 World Health Organization criteria (fasting glucose > or =7.8 mmol/l or 2-h glucose > or =11.1 mmol/l) and the 1997 American Diabetes Association criteria (fasting glucose > or =7.0 mmol/l).
The prevalence of diagnosed and undiagnosed diabetes was 15.6 and 8.0%, respectively, among all participants (NNTS 10.6), 13.9 and 9.1% among white men (NNTS 9.5), 7.8 and 7.4% among white women (NNTS 12.4), 22.7 and 9.1% among black men (NNTS 8.5), and 21.6 and 6.2% among black women (NNTS 12.6). In multivariate analyses, compared with individuals without diabetes, individuals with undiagnosed diabetes were more likely to be men and were more likely to have a history of hypertension, higher BMI, and larger waist circumference. NNTS was lowest in men (9.1), individuals with hypertension (8.7), individuals in the highest BMI quartile (6.9), and individuals in the largest waist circumference quartile (6.8).
In approximately one-third of all older people with diabetes, the condition remains undiagnosed. Screening for diabetes may be more efficient among men and individuals with hypertension, high BMI, and large waist circumference.

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    • "Considering the dangers of not controlling diabetes, it is scary how many have diabetes undiagnosed. The United States estimated to have an undiagnosed diabetes population of 2.7% of the entire adult population over the age of 20 and prevalence of undiagnosed diabetes was similar among white and black men (9.1%) (Franse et al. 2001). In Sardinian population, the prevalence of undiagnosed diabetes was 5.65% (5.20% and 6.15%, females and males, respectively) (Muntoni et al. 2008). "
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    ABSTRACT: Context: Undiagnosed cases of diabetes mellitus constitute a major proportion of diabetic patients in the developing countries due to lack of proper screening and primary care facilities. Generation of evidence on undiagnosed cases is highly important for the estimation of the true burden of this disease. Objectives: The present study was undertaken to explore the proportion of undiagnosed diabetes and associated disorders in a middle aged Bangladeshi population living in the capital city of Bangladesh. Materials and Methods: Under a cross-sectional observational design a group of 254 middle aged (35-60 yrs) subjects (146♂ and 108) were included in the study who previously were unaware about the existence of diabetes or its complications. A 2-sample OGTT was done and blood glucose was estimated by glucose-oxidase method and Serum total cholesterol, HDL and TG by enzymatic colorimetric (Cholesterol Oxidase /Peroxidase, CHOD-PAP) method. Glycemic and other abnormalities were diagnosed and classified as per WHO criteria. Results: Out of the total 254 subjects 34 (15.1%) were found to have type 2 diabetes mellitus (T2DM) and 49 (19.29%) were prediabetics (24.5%-IFG, 75.5% -IGT and 20.4% had combined IFG-IGT). WHR (the indicator of central obesity) was present in higher proportions of diabetic (93.9%) and prediabetics (89.9%) compared to 76.0% control (λ2=8.815; p=0.017). Male subjects had significantly higher central obesity compared to females both in the controls (t=3.929; p<0.0001) and in T2DM groups (t=2.608; p=0.015). Dyslipidemia (judged by triglyceride value) was present among 64.7% in T2DM, 40.8% in Prediabetes and 47.9% in the Controls). In Prediabetes group 80% males had dyslipidemia compared to 20% females (p=0.008). Conclusion: Almost twice the proportion of reported diabetic and prediabetic cases in Bangladesh is still undiagnosed and a substantial proportion of these cases have generalized as well as central obesity and dyslipidemia.
    Journal of Bio-Science 01/2011; DOI:10.3329/jbs.v19i0.12674
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    • "Undiagnosed type 2 diabetes and impaired glucose regulation are reported to have substantial clinical importance. Undiagnosed diabetes may also impose substantial public health implications because these subjects remain untreated and at risk for complications [6]. Although numerous studies have documented worldwide increases in diagnosed and undiagnosed diabetes mellitus, no population based study has been conducted in Qatar to estimate the prevalence of diagnosed and undiagnosed diabetes mellitus, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) among Qatari population. "
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    • "In fact, physicians have long ago noted the connection between obesity, or the reduction of the lean body mass, and a sedentary life (typical of old people) and the development of diabetes (Breecher, 2002; Krebs and Roden, 2005). These modifications occur more frequently in diabetic subjects, so can be used as positive prognostic factors for diabetes (Tafeit et al., 2000; France et al., 2001). The importance of anthropometric indicators, in identification of subjects at risk for several diseases, among them the same diabetes, was reported in the literature (Molarius and Seidell, 1998; NIH, 2000). "
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    ABSTRACT: The aim of this cross-sectional study was to identify the peculiar anthropometric changes in elderly diabetic women aged 70 years and above. The subjects were 91 women suffering from type-2 diabetes and 101 healthy female controls; all these 192 North-Italian women were aged 70 years or over. Eight anthropometric measurements were collected for each subject. We observed significant anthropometric differences between diabetic women and controls. The changes with aging were more evident in women suffering from type-2 diabetes than in controls of the same age groups. In conclusion, the diabetic women are more in overweight than the controls. Moreover, diabetes resulted associated with an accelerated process of aging in anthropometric traits.
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