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: 8.42). 12/2001; 24(12):2065-70. DOI: 10.2337/diacare.24.12.2065
Source: PubMed


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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Available from: Jacques Th M van Eijk, Dec 01, 2015
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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.
    Full-text · Article · Jan 2011 · Journal of Bio-Science
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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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    ABSTRACT: The objective of the study was to determine the prevalence of diagnosed and undiagnosed diabetes, pre-diabetes and to identify the associated risk factors in the sample of adult Qatari population. This was a cross-sectional study. The survey was carried out in urban and semi-urban primary health care centers. The survey was conducted from January 2007 to July 2008 among Qatari nationals above 20 years of age. Of the 1434 subjects who were approached to participate in the study, 1117 (77.9%) gave their consent. Face to face interviews were conducted using a structured questionnaire followed by laboratory tests. DM was defined according to the WHO expert group. Pre diabetes status was based on the presence of impaired fasting glucose or impaired glucose tolerance. The overall prevalence of diabetes mellitus among adult Qatari population was high (16.7%) with diagnosed DM (10.7%) and newly diagnosed DM (5.9%). The impaired glucose tolerance (IGT) was diagnosed in 12.5%, while impaired fasting glucose was in 1.3% with a total of (13.8%). The proportion of DM was higher in Qatari women (53.2%) than in Qatari men (46.8%) and it peaked in the age group 40-49 years (31.2%). The age-specific prevalence of total DM and IGT increased with age. Risk factors were significantly higher in diabetic adult Qatari population: central obesity (p<0.001), hypertension (p<0.001), triglyceride (p<0.001), HDL (p=0.003), metabolic syndrome (p<0.001), heart diseases (p<0.001). Smoking habits and family history of DM were the major contributors for diabetes disease. The central obesity was associated with higher prevalence of DM and IFG among Qatari men and women. The present study has found a moderately high prevalence of diabetes mellitus in the adult Qatari population. High proportion of pre-diabetes in Qatari adults will increase the prevalence of DM in the next few years. Smoking habits and family history of DM were the major contributors for DM. Early diagnosis of DM is of major importance to reduce the risk of these diabetes-related conditions.
    Full-text · Article · Apr 2009 · Diabetes research and clinical practice
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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.
    Full-text · Article · Apr 2008 · Archives of gerontology and geriatrics
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