To compare the racial/ethnic variation in United States prediabetes prevalence estimates for alternative prediabetes definitions currently approved by the American Diabetes Association (ADA) across 20 years and in detailed multivariate comparisons.
Using nationally representative National Health and Nutrition Examination Survey (NHANES) data from 1988-2008, we compared trends in the prevalence of impaired fasting glucose (IFG) and impaired glycated hemoglobin (IGH) for non-Hispanic Black, non-Hispanic White, and Mexican American/other Hispanic adults. Using NHANES 2005-2008, we compared prevalence by race/ethnicity in more detail for the three current ADA prediabetes definitions--IFG, IGH, and impaired glucose tolerance (IGT)--controlling for associated factors (education, income, weight, age, sex).
Prediabetes prevalence during the last 20 years was consistently significantly lower among non-Hispanic Blacks compared to non-Hispanic Whites when measured by IFG, but was significantly higher among non-Hispanic Blacks when measured by IGH. In adjusted models, non-Hispanic Blacks were significantly more likely than non-Hispanic Whites to have IGH (OR: 2.22; 95% CI: 1.33-3.70) and less likely to have IFG (OR: 0.46; 0.30-0.73) or IGT (OR: 0.35; 0.24-0.50), but Mexican American/other Hispanic rates did not differ significantly from non-Hispanic White rates. However, rates of prediabetes, when defined by any of three individual diagnostic criteria, were not statistically significantly different across groups (36.8% for non-Hispanic Whites, 36.0% AA, 37.3% Mexican American/other Hispanics).
National prediabetes prevalence estimates vary dramatically across racial/ethnic groups according to diagnostic method, though over 35% in all three racial/ethnic groups met at least one ADA diagnostic criteria for prediabetes.
"Prediabetes was first recognized as an intermediate diagnosis and indication of a relatively high risk for the future development of diabetes by the Expert Committee on Diagnosis and Classification of Diabetes Mellitus in 1997 , and it has been reported that approximately 5–10% of patients with untreated prediabetes subsequently develop diabetes  . This is significant considering that prediabetes based on impaired fasting glucose (IFG) was estimated to affect 4.9 million people, accounting for 17.4% of Korean adults in 2005 , with a further 35% of adults in the US with prediabetes in 2008 . The definition of prediabetes includes a fasting plasma glucose (FPG) level in the range of 100–125 mg/dL (5.6–6.9 mmol/L), impaired glucose tolerance (IGT) (oral glucose tolerance test (OGTT) 2 h measurement in the range of 140–199 mg/dL (7. "
[Show abstract][Hide abstract] ABSTRACT: The global prevalence of diabetes is rapidly increasing. Studies support the necessity of screening and interventions for prediabetes, which could result in serious complications and diabetes. This study aimed at developing an intelligence-based screening model for prediabetes. Data from the Korean National Health and Nutrition Examination Survey (KNHANES) were used, excluding subjects with diabetes. The KNHANES 2010 data (n = 4685) were used for training and internal validation, while data from KNHANES 2011 (n = 4566) were used for external validation. We developed two models to screen for prediabetes using an artificial neural network (ANN) and support vector machine (SVM) and performed a systematic evaluation of the models using internal and external validation. We compared the performance of our models with that of a screening score model based on logistic regression analysis for prediabetes that had been developed previously. The SVM model showed the areas under the curve of 0.731 in the external datasets, which is higher than those of the ANN model (0.729) and the screening score model (0.712), respectively. The prescreening methods developed in this study performed better than the screening score model that had been developed previously and may be more effective method for prediabetes screening.
Computational and Mathematical Methods in Medicine 07/2014; 2014(3):618976. DOI:10.1155/2014/618976 · 0.77 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The annual number of living kidney donors in the United States peaked at 6647 in 2004. The preceding decade saw a 120% increase in living kidney donation. However, since 2004, living kidney donation has declined in all but 1 year, resulting in a 13% decline in the annual number of living kidney donors from 2004 to 2011. The proportional decline in living kidney donation has been more pronounced among men, blacks, younger adults, siblings, and parents. In this article, we explore several possible explanations for the decline in living kidney donation, including an increase in medical unsuitability, an aging transplant patient population, financial disincentives, public policies, and shifting practice patterns, among others. We conclude that the decline in living donation is not merely reflective of random variation but one that warrants action by the transplant centers, the broader transplant community, and the state and national governments.
[Show abstract][Hide abstract] ABSTRACT: To investigate normoglycemic, prediabetic and diabetic A1c levels in those with prediabetes; and prediabetic and diabetic A1c levels in those with non-prediabetes.
The National Health and Nutritional Examination Survey (NHANES) 2007-2008 and NHANES 2009-2010 were utilized to examine and compare trends and differences among five different ethnic groups (Mexican Americans, Other Hispanics, Non-Hispanic Whites, Non-Hispanic Blacks, Other/Multi-racials) with normoglycemic, prediabetic and diabetic A1c levels with self-reported prediabetes and prediabetic and diabetic A1c levels in those with self-reported non-prediabetes. Sample participants of the five ethnic groups were limited to those 20 years of age and older, who had completed the diabetes questionnaire and had A1c measured. Descriptive statistics were computed for all variables. χ(2) were performed on all five ethnic groups to examine significant differences of normoglycemic, prediabetic and diabetic A1c levels in those with self-reported prediabetes, and prediabetic and diabetic A1c levels in those with self-reported non-prediabetes.
This study demonstrates that of the five different ethnic groups from NHANES 2007-2008 to NHANES 2009-2010, Non-Hispanic Whites (6.5% increase) and Non-Hispanic Blacks (0.2% increase) were the only two groups with an increase in the number of self-reported prediabetes. Although the overall percentage of Mexican Americans who self-reported prediabetes had remained the same (5%) from NHANES 2007-2008 to NHANES 2009-2010, χ(2) analysis showed significant differences when examining the different ranges of A1c levels (normoglycemic, prediabetic and diabetic). Among Mexican Americans who self-reported prediabetes, normoglycemic (P = 0.0001) and diabetic (P = 0.0001) A1c levels from NHANES 2007-2008 to NHANES 2009-2010. For Non-Hispanic Whites who self-reported prediabetes, prediabetic (P = 0.0222); and diabetic (P ≤ 0.0001) A1c levels from NHANES 2007-2008 to NHANES 2009-2010. For Non-Hispanic Blacks who self-reported prediabetes, there were significant differences (P = 0.0001) for all A1c levels (normoglycemic, prediabetic and diabetic A1c levels). For Other/Multi-racials with self-reported prediabetes there was significant differences in those with normoglycemic (P = 0.0104) and diabetic (P = 0.0067) A1c levels from NHANES 2007-2008 to NHANES 2009-2010. For all combined ethnic groups who self-reported not having prediabetes (non-prediabetes), 19.9% of those in NHANES 2007-2008 and 22.4% in the NHANES 2009-2010 showed to have prediabetic A1c levels. When separately examining each of the five ethnic groups who self-reported not having prediabetes, all showed an increase in those with prediabetic A1c levels from NHANES 2007-2008 to NHANES 2009-2010. Through χ(2) analysis, all five ethnic groups who self-reported not having prediabetes showed significant differences (P < 0.0001) in all A1c levels (normoglycemic, prediabetic and diabetic) from NHANES 2007-2008 to NHANES 2009-2010.
The findings highlight the need of prediabetes awareness and of education in the community as ways to reduce the number of people with prediabetes.
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