Trends in Prevalence and Control of Diabetes in the United States, 1988–1994 and 1999–2010
Open accessAbstract
BACKGROUND: Trends in the prevalence and control of diabetes defined by hemoglobin A1c (HbA1c) levels are important for health care policy and planning. OBJECTIVE: To update trends in the prevalence of diabetes, prediabetes, and glycemic control. DESIGN: Cross-sectional. SETTING: NHANES (National Health and Nutrition Examination Survey) in 1988-1994 and 1999-2010. PARTICIPANTS: Adults aged 20 years or older. MEASUREMENTS: We used calibrated HbA1c levels to define undiagnosed diabetes (≥6.5%); prediabetes (5.7% to 6.4%); and, among persons with diagnosed diabetes, glycemic control (<7.0% or <8.0%). Trends in HbA1c categories were compared with fasting glucose levels (≥7.0 mmol/L [≥126 mg/dL] and 5.6 to 6.9 mmol/L [100 to 125 mg/dL]). RESULTS: In 2010, approximately 21 million U.S. adults aged 20 years or older had total confirmed diabetes (self-reported diabetes or diagnostic levels for both fasting glucose and calibrated HbA1c). During 2 decades, the prevalence of total confirmed diabetes increased, but the prevalence of undiagnosed diabetes remained fairly stable, reducing the proportion of total diabetes cases that are undiagnosed to 11% in 2005-2010. The prevalence of prediabetes was lower when defined by calibrated HbA1c levels than when defined by fasting glucose levels but has increased from 5.8% in 1988-1994 to 12.4% in 2005-2010 when defined by HbA1c levels. Glycemic control improved overall, but total diabetes prevalence was greater and diabetes was less controlled among non-Hispanic blacks and Mexican Americans compared with non-Hispanic whites. LIMITATION: Cross-sectional design. CONCLUSION: Over the past 2 decades, the prevalence of total diabetes has increased substantially. However, the proportion of undiagnosed diabetes cases decreased, suggesting improvements in screening and diagnosis. Among the growing number of persons with diagnosed diabetes, glycemic control improved but remains a challenge, particularly among non-Hispanic blacks and Mexican Americans. PRIMARY FUNDING SOURCE: National Institutes of Health.
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Approximately half of treated patients do not have adequate blood pressure or glycemic control.
“Despite the widespread availability of effective treatments, approximately half of treated patients do not have adequate blood pressure (BP) or glycemic control [4,6,7].”
From Effectiveness of Digital Medicines to Improve Clinical Outcomes in Patients with Uncontrolled Hypertension and Type 2 Diabetes: Prospective, Open-Label, Cluster-Randomized Pilot Clinical Trial (2017) · cites this paper as [7]
The Results report that 55.1% of adults taking diabetes medication had HbA1c below 7.0% in 2005–2010, supporting the claim that approximately half lacked glycemic control. The cited passage does not report blood-pressure control among treated patients. Page numbers are unavailable in our copy. (LLM, conf=0.86)
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- Authors
- Selvin, E., Parrinello, C. M., Sacks, D. B., & Coresh, J.
- Affiliations
- National Institutes of Health (US)
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2014-04-15
- Volume
- 160
- Issue
- 8
- Pages
- 517-525
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- PMC
- PMC4442608
- OpenAlex
- W1996716751
- Cited by
- 532
- References
- 31
- Citations by year
- 2026: 5 · 2025: 18 · 2024: 19 · 2023: 20 · 2022: 29 · 2021: 41 · 2020: 43 · 2019: 50 · 2018: 53 · 2017: 59 · 2016: 74 · 2015: 81 · 2014: 39
- FWCI
- 67.87
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (T32HL007024)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK089174)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- diabetes prevalence, prediabetes, glycemic control, HbA1c, undiagnosed diabetes, fasting blood glucose, diabetes screening, racial disparities, non-Hispanic blacks, Mexican Americans, NHANES, temporal trends, diabetes diagnosis, United States adults
- MeSH terms
- Adult, Aged, Black or African American, Blood Glucose, Cross-Sectional Studies, Diabetes Mellitus, Fasting, Female, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Male, Nutrition Surveys, Obesity, Prediabetic State, United States, Comorbidity, Prevalence, Mexican Americans, Black People, Young Adult
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