Trends in Prevalence of Diabetes and Control of Risk Factors in Diabetes Among US Adults, 1999-2018

IMPORTANCE: Understanding population-wide trends in prevalence and control of diabetes is critical to planning public health approaches for prevention and management of the disease. OBJECTIVE: To determine trends in prevalence of diabetes and control of risk factors in diabetes among US adults betwe...

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Published in:JAMA : the journal of the American Medical Association 2021-08, Vol.326 (8), p.704-716
Main Authors: Wang, Li, Li, Xiaoguang, Wang, Zhaoxin, Bancks, Michael P, Carnethon, Mercedes R, Greenland, Philip, Feng, Ying-Qing, Wang, Hui, Zhong, Victor W
Format: Article
Language:English
Subjects:
Adults
Age
Blood pressure
Cholesterol
Density
Diabetes
Diabetes mellitus
Health risks
Hemoglobin
Hispanic people
Lipoproteins
Men
Nutrition
Older people
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Original Investigation
Polls & surveys
Public health
Risk analysis
Risk factors
Risk management
Trends
Young adults
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Summary:IMPORTANCE: Understanding population-wide trends in prevalence and control of diabetes is critical to planning public health approaches for prevention and management of the disease. OBJECTIVE: To determine trends in prevalence of diabetes and control of risk factors in diabetes among US adults between 1999-2000 and 2017-2018. DESIGN, SETTING, AND PARTICIPANTS: Ten cycles of cross-sectional National Health and Nutrition Examination Survey (NHANES) data between 1999-2000 and 2017-2018 were included. The study samples were weighted to be representative of the noninstitutionalized civilian resident US population. Adults aged 18 years or older were included, except pregnant women. EXPOSURES: Survey cycle. MAIN OUTCOMES AND MEASURES: Diabetes was defined by self-report of diabetes diagnosis, fasting plasma glucose level of 126 mg/dL or more, or hemoglobin A1c (HbA1c) level of 6.5% or more. Three risk factor control goals were individualized HbA1c targets, blood pressure less than 130/80 mm Hg, and low-density lipoprotein cholesterol level less than 100 mg/dL. Prevalence of diabetes and proportion of adults with diagnosed diabetes who achieved risk factor control goals, overall and by sociodemographic variables, were estimated. RESULTS: Among the 28 143 participants included (weighted mean age, 48.2 years; 49.3% men), the estimated age-standardized prevalence of diabetes increased significantly from 9.8% (95% CI, 8.6%-11.1%) in 1999-2000 to 14.3% (95% CI, 12.9%-15.8%) in 2017-2018 (P for trend
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2021.9883