PREVALENCE OF DIABETES, IMPAIRED FASTING GLUCOSE, AND IMPAIRED GLUCOSE-TOLERANCE IN US ADULTS - THE -NATIONAL-HEALTH-AND-NUTRITION-EXAMINATION-SURVEY, 1988-1994

OBJECTIVE - To evaluate the prevalence and time trends for diagnosed a nd undiagnosed diabetes, impaired fasting glucose, and impaired glucos e tolerance in U.S. adults by age, sex, and race or ethnic group, base d on data from the Third National Health and Nutrition Examination Sur vey, 1988-1994 (NHANES III) and prior Health and Nutrition Examination Surveys (HANESs). RESEARCH DESIGN AND METHODS - NHANES III contained a probability sample of 18,825 U.S. adults greater than or equal to 20 years of age who were interviewed to ascertain a medical history of d iagnosed diabetes, a subsample of 6,587 adults for whom fasting plasma glucose values were obtained, and a subsample of 2,844 adults between 40 and 74 years of age who received an oral glucose tolerance test. T he Second National Health and Nutrition Examination Survey, 1976-1980, and Hispanic HANES used similar procedures to ascertain diabetes. Pre valence was calculated using the 1997 American Diabetes Association fa sting plasma glucose criteria and the 1980-1985 World Health Organizat ion (WHO) oral glucose tolerance test criteria. RESULTS - Prevalence o f diagnosed diabetes in 1988-1994 was estimated to be 5.1% for U.S. ad ults greater than or equal to 20 years of age (10.2 million people whe n extrapolated to the 1997 U.S. population). Using American Diabetes A ssociation criteria, the prevalence of undiagnosed diabetes (fasting p lasma glucose greater than or equal to 126 mg/dl) was 2.7% (5.4 millio n), and the prevalence of impaired fasting glucose (110 to <126 mg/dl) was 6.9% (13.4 million). There were similar rates of diabetes for men and women, but the rates for non-Hispanic blacks and Mexican-American s were 1.6 and 1.9 times the rate for non-Hispanic whites. Based on Am erican Diabetes Association criteria, prevalence of diabetes (diagnose d plus undiagnosed) in the total population of people who were 40-74 y ears of age increased from 8.9% in the period 1976-1980 to 12.3% by 19 88-1994. A similar increase was found when WHO criteria were applied ( 11.4 and 14.3%). CONCLUSIONS - The high rates of abnormal fasting and postchallenge glucose found in NHANES III, together with the increasin g frequency of obesity and sedentary lifestyles in the population, mak e it likely that diabetes will continue to be a major health problem i n the U.S.