Trends in Prevalence of Diabetes, Pre-Diabetes, and Cardiometabolic Risk Factor Control Among U.S. Adults, 2013-2023.
Level 4 - case-series / case-control
Repeated cross-sectional survey analysis of nationally representative observational data (NHANES).
PubMed 42396720 · doi:10.1111/dom.71059
What was done
A repeated cross-sectional study analyzed data from 24,230 adults aged ≥20 years participating in four continuous cycles of the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2023. The authors calculated age-standardized prevalence and linear trends (via logistic regression) for pre-diabetes, diagnosed diabetes, undiagnosed diabetes, total diabetes, and attainment of glycemic, blood pressure, and lipid control targets.
What was found
Across the 24,230 participants, 6,773 had pre-diabetes and 4,784 had diabetes (3,826 diagnosed and 958 undiagnosed). Age-adjusted total diabetes prevalence remained stable over the period: 14.6% (95% CI, 13.0%–16.2%) in 2013–2014 versus 16.3% (95% CI, 14.6%–18.0%) in 2021–2023 (prevalence ratio [PR] 1.07, 95% CI 0.90–1.26; p-trend = 0.47). In contrast, age-adjusted pre-diabetes prevalence increased from 26.4% (95% CI, 23.7%–29.1%) in 2013–2014 to 30.7% (95% CI, 28.4%–33.0%) in 2021–2023 (PR 1.12, 95% CI 1.02–1.23; p-trend = 0.04). Specific numerical findings for cardiometabolic target control were not reported in the abstract.
Why it matters
Although US adult diabetes prevalence has plateaued over the past decade, the significant rise in pre-diabetes indicates an expanding population at elevated risk for future cardiometabolic and renal disease.
Limits
The repeated cross-sectional design cannot follow individual trajectories or establish causality. The abstract omits specific numerical findings for cardiometabolic risk factor control (blood pressure, lipids, and glycemic targets) despite listing them in the methods. Survey participation rates and self-reported diagnosis measures are susceptible to nonresponse and recall biases.
Cited by
- supports Approximately 50% of American adults have either prediabetes or type 2 diabetes.