Type 2 diabetes in older well-functioning people: Who is undiagnosed? Datafrom the Health, Aging, and Body Composition Study

OBJECTIVE - To assess, in an older population, the prevalence of diagnosed and undiagnosed diabetes, the number needed to screen (NNTS) to identify on e individual with undiagnosed diabetes, and factors associated with undiagn osed diabetes. RESEARCH DESIGN AND METHODS - Socioeconomic and health-related factors were assessed at the baseline examination of the Health, Aging, and Body Compos ition (Health ABC) Study, a cohort of 3,075 well-functioning people aged 70 -79 years living in Memphis, Tennessee and Pittsburgh, Pennsylvania (42% bl acks and 48% men). Diabetes was defined according to the 1985 World Health Organization criteria (fasting glucose greater than or equal to7.8 mmol/l o r 2-h glucose greater than or equal to 11.1 mmol/l) and the 1997 American D iabetes Association criteria (fasting glucose greater than or equal to7.0 m mol/l). RESULTS - The prevalence of diagnosed and undiagnosed diabetes was 15.6 and 8.0%, respectively, among all participants (NNTS 10.6), 13.9 and 9.1% amon g white men (NNTS 9.5), 7.8 and 7.4% among white women (NNTS 12.4), 22.7 an d 9.1% among black men (NNTS 8.5), and 21.6 and 6.2% among black women (NNT S 12.6). In multivariate analyses, compared with individuals without diabet es, individuals with undiagnosed diabetes were more likely to be men and we re more likely to have a history of hypertension, higher BMI, and larger wa ist circumference. NNTS was lowest in men (9.1), individuals with hypertens ion (8.7), individuals in the highest BMI quartile (6.9), and individuals f it the largest, waist circumference quartile (6.8). CONCLUSIONS - In approximately one-third of all older people with diabetes, the condition remains undiagnosed. Screening for diabetes may be more effi cient among men and individuals with hypertension, high BMI, and large wais t circumference.