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Secular changes in U.S. Prediabetes prevalence defined by hemoglobin A1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999-2010.
Diabetes Care. 2013 Aug; 36(8):2286-93.DC

Abstract

OBJECTIVE

Using a nationally representative sample of the civilian noninstitutionalized U.S. population, we estimated prediabetes prevalence and its changes during 1999-2010.

RESEARCH DESIGN AND METHODS

Data were from 19,182 nonpregnant individuals aged ≥ 12 years who participated in the 1999-2010 National Health and Nutrition Examination Surveys. We defined prediabetes as hemoglobin A1c (A1C) 5.7 to <6.5% (39 to <48 mmol/mol, A1C5.7) or fasting plasma glucose (FPG) 100 to <126 mg/dL (impaired fasting glucose [IFG]). We estimated the prevalence of prediabetes, A1C5.7, and IFG for 1999-2002, 2003-2006, and 2007-2010. We calculated estimates age-standardized to the 2000 U.S. census population and used logistic regression to compute estimates adjusted for age, sex, race/ethnicity, poverty-to-income ratio, and BMI. Participants with self-reported diabetes, A1C ≥ 6.5% (≥ 48 mmol/mol), or FPG ≥126 mg/dL were included.

RESULTS

Among those aged ≥ 12 years, age-adjusted prediabetes prevalence increased from 27.4% (95% CI 25.1-29.7) in 1999-2002 to 34.1% (32.5-35.8) in 2007-2010. Among adults aged ≥ 18 years, the prevalence increased from 29.2% (26.8-31.8) to 36.2% (34.5-38.0). As single measures among individuals aged ≥ 12 years, A1C5.7 prevalence increased from 9.5% (8.4-10.8) to 17.8% (16.6-19.0), a relative increase of 87%, whereas IFG remained stable. These prevalence changes were similar among the total population, across subgroups, and after controlling for covariates.

CONCLUSIONS

During 1999-2010, U.S. prediabetes prevalence increased because of increases in A1C5.7. Continuous monitoring of prediabetes is needed to identify, quantify, and characterize the population of high-risk individuals targeted for ongoing diabetes primary prevention efforts.

Authors+Show Affiliations

Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. hjo1@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23603918

Citation

Bullard, Kai McKeever, et al. "Secular Changes in U.S. Prediabetes Prevalence Defined By Hemoglobin A1c and Fasting Plasma Glucose: National Health and Nutrition Examination Surveys, 1999-2010." Diabetes Care, vol. 36, no. 8, 2013, pp. 2286-93.
Bullard KM, Saydah SH, Imperatore G, et al. Secular changes in U.S. Prediabetes prevalence defined by hemoglobin A1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999-2010. Diabetes Care. 2013;36(8):2286-93.
Bullard, K. M., Saydah, S. H., Imperatore, G., Cowie, C. C., Gregg, E. W., Geiss, L. S., Cheng, Y. J., Rolka, D. B., Williams, D. E., & Caspersen, C. J. (2013). Secular changes in U.S. Prediabetes prevalence defined by hemoglobin A1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999-2010. Diabetes Care, 36(8), 2286-93. https://doi.org/10.2337/dc12-2563
Bullard KM, et al. Secular Changes in U.S. Prediabetes Prevalence Defined By Hemoglobin A1c and Fasting Plasma Glucose: National Health and Nutrition Examination Surveys, 1999-2010. Diabetes Care. 2013;36(8):2286-93. PubMed PMID: 23603918.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Secular changes in U.S. Prediabetes prevalence defined by hemoglobin A1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999-2010. AU - Bullard,Kai McKeever, AU - Saydah,Sharon H, AU - Imperatore,Giuseppina, AU - Cowie,Catherine C, AU - Gregg,Edward W, AU - Geiss,Linda S, AU - Cheng,Yiling J, AU - Rolka,Deborah B, AU - Williams,Desmond E, AU - Caspersen,Carl J, Y1 - 2013/04/19/ PY - 2013/4/23/entrez PY - 2013/4/23/pubmed PY - 2014/3/19/medline SP - 2286 EP - 93 JF - Diabetes care JO - Diabetes Care VL - 36 IS - 8 N2 - OBJECTIVE: Using a nationally representative sample of the civilian noninstitutionalized U.S. population, we estimated prediabetes prevalence and its changes during 1999-2010. RESEARCH DESIGN AND METHODS: Data were from 19,182 nonpregnant individuals aged ≥ 12 years who participated in the 1999-2010 National Health and Nutrition Examination Surveys. We defined prediabetes as hemoglobin A1c (A1C) 5.7 to <6.5% (39 to <48 mmol/mol, A1C5.7) or fasting plasma glucose (FPG) 100 to <126 mg/dL (impaired fasting glucose [IFG]). We estimated the prevalence of prediabetes, A1C5.7, and IFG for 1999-2002, 2003-2006, and 2007-2010. We calculated estimates age-standardized to the 2000 U.S. census population and used logistic regression to compute estimates adjusted for age, sex, race/ethnicity, poverty-to-income ratio, and BMI. Participants with self-reported diabetes, A1C ≥ 6.5% (≥ 48 mmol/mol), or FPG ≥126 mg/dL were included. RESULTS: Among those aged ≥ 12 years, age-adjusted prediabetes prevalence increased from 27.4% (95% CI 25.1-29.7) in 1999-2002 to 34.1% (32.5-35.8) in 2007-2010. Among adults aged ≥ 18 years, the prevalence increased from 29.2% (26.8-31.8) to 36.2% (34.5-38.0). As single measures among individuals aged ≥ 12 years, A1C5.7 prevalence increased from 9.5% (8.4-10.8) to 17.8% (16.6-19.0), a relative increase of 87%, whereas IFG remained stable. These prevalence changes were similar among the total population, across subgroups, and after controlling for covariates. CONCLUSIONS: During 1999-2010, U.S. prediabetes prevalence increased because of increases in A1C5.7. Continuous monitoring of prediabetes is needed to identify, quantify, and characterize the population of high-risk individuals targeted for ongoing diabetes primary prevention efforts. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/23603918/Secular_changes_in_U_S__Prediabetes_prevalence_defined_by_hemoglobin_A1c_and_fasting_plasma_glucose:_National_Health_and_Nutrition_Examination_Surveys_1999_2010_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=23603918 DB - PRIME DP - Unbound Medicine ER -