Many People Have Diabetes Without Knowing It
Nearly 3 percent of US adults - one-third of those with diabetes - do not know they have it, according to a report in Diabetes Care.
The percentage of adults with undiagnosed diabetes has not changed significantly in recent years.
The percentage of adults ages 20 and older in the US has grown from about 5 percent to 6.5 percent, according to researchers at the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC).
Scientists analyzed national survey data from two periods - 1988 to 1994 and 1999 to 2002.
The study notes that type 2 diabetes accounts for up to 95 percent of all diabetes cases and virtually all undiagnosed diabetes cases.
Healthy Lifestyle Encouraged
Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.
It is the most common cause of blindness, kidney failure, and amputations in adults and a major cause of heart disease and stroke.
Over the years studied, about 26 percent of adults age 20 and older continued to have impaired fasting glucose (IFG), a form of prediabetes.
IFG, in which blood glucose measured after an overnight fast is high but not yet diagnostic of diabetes, increases the risk of heart disease as well as the risk of developing type 2 diabetes.
“It’s important to know if you have pre-diabetes or undiagnosed type 2 diabetes,” says Dr. Larry Blonde, chair of the National Diabetes Education Program (NDEP), jointly sponsored by the NIH, CDC, and 200 partner organizations.
“You should talk to your health care professional about your risk,” says Dr. Blonde. “If your blood glucose is high but not high enough to be diagnosed as diabetes, losing weight and increasing physical activity will greatly lower your risk of getting type 2 diabetes.
"If you have diabetes, controlling your blood glucose, blood pressure, and cholesterol will prevent or delay the complications of diabetes,” remarks Dr. Blonde.
The researchers also found that:
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nearly 22 percent of people ages 65 and older had diabetes.
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about 13 percent of non-Hispanic African Americans ages 20 and older had diabetes. Diabetes was twice as common in non-Hispanic African Americans compared to non-Hispanic Caucasians.
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about 8 percent of Mexican Americans ages 20 and older had diabetes. Because the average age of Mexican Americans is younger than for other groups, the age-and sex-adjusted prevalence of diabetes in Mexican Americans is twice that of non-Hispanic Caucasians and about equal to that of non-Hispanic African Americans.
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IFG and undiagnosed diabetes were about 70 percent more common in men than in women, especially in non-Hispanic Caucasian men.
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nearly 40 percent of people ages 65 and older had IFG, which becomes more common with age.
The information studied was taken from a national sample of US adults ages 20 years and older who took part in the National Health and Nutrition Examination Survey (NHANES) conducted by the CDC National Center for Health Statistics.
Survey participants were interviewed in their homes and received a physical exam with a blood test, which included a glucose reading taken after an overnight fast.
The NHANES is unique because it includes a blood test that detects undiagnosed diabetes and IFG.
“This study updates and generally corroborates earlier analyses that were based on two years of NHANES data,” says lead author Dr. Catherine Cowie, of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
“We’re seeing a rising prevalence of diagnosed diabetes that is not substantially offset by a drop in the rate of undiagnosed - about one-third of adults with diabetes still don’t know they have it," says Dr. Cowie.
"Another 26 percent of adults have a form of prediabetes,” she says.
Prediabetes, which usually causes no symptoms, is serious because many people with the condition develop type 2 diabetes in the next 10 years.
Also, prediabetes substantially raises the risk of a heart attack or stroke even if type 2 diabetes does not develop.
People with prediabetes may have IFG or impaired glucose tolerance (IGT) or both.
Always consult your physician for more information.
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A major study of people with impaired glucose tolerance (IGT) has shown that lifestyle changes leading to a 5 percent to 7 percent weight loss lowered diabetes onset by 58 percent.
If a person is over age 45, he or she should consult a health care provider about testing for prediabetes or diabetes.
If an individual is younger than 45, overweight, and has another risk factor, testing should be requested, the experts say.
A person is at greater risk of developing prediabetes and type 2 diabetes if he or she:
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is age 45 or older
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has a family history of diabetes
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is overweight
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has an inactive lifestyle (exercise less than three times a week)
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is a member of a high-risk ethnic population (e.g., African American, Hispanic/Latino American, American Indian and Alaska Native, Asian American, Pacific Islander)
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has high blood pressure: 140/90 mm/Hg or higher
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has an HDL cholesterol less than 35 mg/dL or a triglyceride level 250 mg/dL or higher
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has had diabetes that developed during pregnancy (gestational diabetes) or has given birth to a baby weighing more than 9 pounds
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has polycystic ovary syndrome, a metabolic disorder that affects the female reproductive system
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has acanthosis nigricans (dark, thickened skin around neck or armpits)
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has a history of disease of the blood vessels to the heart, brain, or legs
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has had IFG or IGT on previous testing
In its “Small Steps. Big Rewards. Prevent Type 2 Diabetes” campaign, the National Diabetes Education Program (NDEP) is reaching out to people at risk for type 2 diabetes with the message that they have the power to turn the tide against this disease.
Another NDEP campaign, “Control Your Diabetes for Life,” encourages people with diabetes to control their blood glucose as well as their blood pressure and cholesterol.
By keeping all three as close to normal as possible, people with diabetes can prevent or delay the development and progression of diabetes complications, which affect the heart, eyes, nerves, kidneys, and blood vessels.
Always consult your physician for more information.
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