Prevalence, diagnosis, and treatment of impaired fasting glucose and impaired glucose tolerance in nondiabetic U.S. adults.
Level 4 - case-series / case-control
Cross-sectional population survey (NHANES)
PubMed 20724649 · doi:10.2337/dc09-1957
What was done
The authors analyzed data from 1,547 nondiabetic adults (>18 years old) without a history of myocardial infarction from the 2005–2006 National Health and Nutrition Examination Survey (NHANES). They assessed the prevalence of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), the proportion receiving a physician diagnosis, and the rates of lifestyle recommendations and pharmacotherapy using multivariable regression.
What was found
Pre-diabetes was present in 34.6% (CI 30.3–38.9%) of participants, comprising 19.4% with IFG only, 5.4% with IGT only, and 9.8% with both IFG and IGT. Only 4.8% of individuals with pre-diabetes reported receiving a formal diagnosis from their physician. No participants with pre-diabetes received oral antihyperglycemic medications. Physician recommendations for exercise and diet were reported by 31.7% and 33.5% of pre-diabetic individuals, respectively. Among the 47.7% of pre-diabetic participants who exercised, 49.4% reported exercising for at least 30 minutes daily.
Why it matters
Despite established evidence showing that early interventions substantially reduce progression to type 2 diabetes, the overwhelming majority of affected individuals in the US population remained undiagnosed and untreated.
Limits
The study is cross-sectional and cannot track long-term clinical outcomes. Diagnosis, physician advice, and exercise behavior were based on self-report rather than medical records, introducing potential recall bias. Individuals with prior myocardial infarction were excluded, which limits generalizability to cardiovascular disease populations.
Cited by
- supports Approximately 90 percent of metabolic disease cases have not been diagnosed by typical healthcare providers.