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US diabetes detection rates remain low for some populations
The overall detection rate of undiagnosed type 2 diabetes in the United States did not increase between 1999 and 2014, despite small improvements among white and older adults, according to an analysis of National Health and Nutrition Examination Survey data.
In fact, the probability of disease detection decreased among Mexican-Americans, according to researchers.
“These findings stand in contrast to impressions that we are now doing a better job of detecting diabetes, and our findings suggest that this is only true for some sociodemographic groups,” Linda S. Geiss, MS, a statistician with the division of diabetes translation at the CDC, and colleagues wrote.
Geiss and colleagues analyzed data from 16,644 participants without a previous diagnosis of diabetes who participated in the 1999-2014 NHANES cycles, averaging about 2,000 participants for each 2-year cycle. The measure of case detection was the probability of finding an undiagnosed case of type 2 diabetes among the population without diagnosed diabetes. Researchers calculated nationally representative estimates of the probability of finding undiagnosed diabetes and stratified probability estimates by sociodemographic characteristics.
During the 1999-2000 NHANES cycle, the age-standardized probability of finding undiagnosed type 2 diabetes was 3% (95% CI, 2.1-4.2), falling slightly to 2.8% (95% CI, 2.2-3.4) during the 2013-2014 cycle (P for trend = .52). When stratified by sociodemographic subgroups, researchers observed a marked increase in the probability of finding undiagnosed diabetes among Mexican-Americans, rising from 3.7% during the 1999-2002 cycles to 6% during the 2011-2014 cycles (P for trend = .01). Researchers observed small decreases from 1999 to 2014 in the probability of finding undiagnosed diabetes among adults aged at least 65 years (P for trend = .04), white adults (P for trend = .02) and adults in the highest income-to-poverty ratio (P for trend = .047).
During the 2011-2014 cycles, the probability of finding undiagnosed type 2 diabetes was higher among adults aged at least 65 years vs. those aged 18 to 44 years (5.6% vs. 1.3%), higher among men vs. women (3.7% vs. 2.6%), and higher among black and Mexican-American adults vs. white adults (5.5% vs. 6% vs. 2.2%, respectively).
The researchers noted that the findings of improved detection among select groups might be caused by increasing rates of testing for diabetes among those with access to health care.
“As additional prevention efforts are made to identify those at high risk of developing diabetes, case identification of undiagnosed type 2 diabetes may improve,” the researchers wrote. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.