Thirty-Year Trends in Complications in U.S. Adults With Newly Diagnosed Type 2 Diabetes
Open accessAbstract
OBJECTIVE: To assess the prevalence of and trends in complications among U.S. adults with newly diagnosed diabetes. RESEARCH DESIGN AND METHODS: We included 1,486 nonpregnant adults (aged ≥20 years) with newly diagnosed diabetes (diagnosed within the past 2 years) from the 1988–1994 and 1999–2018 National Health and Nutrition Examination Survey. We estimated trends in albuminuria (albumin-to-creatinine ratio ≥30 mg/g), reduced estimated glomerular filtration rate (eGFR <60 mL/min/1.73 m2), retinopathy (any retinal microaneurysms or blot hemorrhages), and self-reported cardiovascular disease (history of congestive heart failure, heart attack, or stroke). RESULTS: From 1988–1994 to 2011–2018, there was a significant decrease in the prevalence of albuminuria (38.9 to 18.7%, P for trend <0.001) but no change in the prevalence of reduced eGFR (7.5 to 9.9%, P for trend = 0.30), retinopathy (1988–1994 to 1999–2008 only; 13.2 to 12.1%, P for trend = 0.86), or self-reported cardiovascular disease (19.0 to 16.5%, P for trend = 0.64). There were improvements in glycemic, blood pressure, and lipid control in the population, and these partially explained the decline in albuminuria. Complications were more common at the time of diabetes diagnosis for adults who were older, lower income, less educated, and obese. CONCLUSIONS: Over the past three decades, there have been encouraging reductions in albuminuria and risk factor control in adults with newly diagnosed diabetes. However, the overall burden of complications around the time of the diagnosis remains high.
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Despite improvements in screening and expanded treatment options, the prevalence of stroke in people with diabetes has remained relatively stable, indicating a persistent care gap.
“Despite improvements in screening for diabetes and an expanded diabetes and stroke reduction armamentarium, the prevalence of stroke in individuals with diabetes has remained relatively stable, 6 underscoring a persistent care gap.”
From Benefits of GLP-1 (Glucagon-Like Peptide 1) Receptor Agonists for Stroke Reduction in Type 2 Diabetes: A Call to Action for Neurologists (2022) · cites this paper as [6]
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- Authors
- Fang, M., & Selvin, E.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Selvin, Elizabeth
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2021-01-08
- Volume
- 44
- Issue
- 3
- Pages
- 699-706
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC7896270
- OpenAlex
- W3120365447
- Cited by
- 59
- References
- 53
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 12 · 2023: 8 · 2022: 15 · 2021: 7
- FWCI
- 7.83
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart Lung and Blood Institute (T32 HL007024)
- National Institute of Diabetes and Digestive and Kidney Diseases (K24 DK106414)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, newly diagnosed diabetes, diabetes complications, albuminuria, estimated glomerular filtration rate, diabetic retinopathy, cardiovascular disease, temporal trends, glycemic control, blood pressure control, lipid control, socioeconomic disparities, obesity, NHANES
- MeSH terms
- Adult, Albuminuria, Diabetes Mellitus, Type 2, Glomerular Filtration Rate, Humans, Myocardial Infarction, Nutrition Surveys, Risk Factors, Prevalence
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