Racial/ethnic variation in prevalence estimates for United States prediabetes under alternative 2010 American Diabetes Association criteria: 1988-2008

ArticleinEthnicity & disease 22(4):451-8 · November 2012with15 Reads
Source: PubMed
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 [14], and it has been reported that approximately 5–10% of patients with untreated prediabetes subsequently develop diabetes [15, 16]. 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 [6], with a further 35% of adults in the US with prediabetes in 2008 [17]. 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 (7.8–11.0 "
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