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Dx Diabetes Incidence Increasing: Read More...


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Observation:
Diabetes prevalence rising, especially among minorities:
reproduced from OB GYN NEWS October 2015;page 3

"The prevalence of diabetes in the United States was 12%- 14% in 2011-2012 with higher rates in black, Asian and Hispanic populations.

Over the past decade, the prevalence of diabetes has increased, placing it as a major cause of morbidity in the United States. Andy Menke, Ph.D. of Social and Scientific systems, a biotechnology company in Silver springs, Md., and his colleagues sought to estimate the U.S. trends and prevalence of pre-diabetes,total diabetes, diagnosed diabetes, and undiagnosed diabetes using data from the National Health and Nutrition Examination Survey (NHAMES). Their results were published in the Journal of the American Medical Association.

To estimate the most recent prevalence, the investigators sampled 2,781 adults from the 2011-2012 data and included 23,634 adults to estimate the trends from 1988- 2010.

The prevalence of diabetes was determined based on a diagnosis of diabetes or evidence of based on fasting plasma glucose greater than 126mg/dl, a hemoglobin A1c of 6.5% or more or a 2-hour post-prandial glucose greater than 200 mg/dl.

Pre-diabetes was noted to be based on a 2-hour post-prandial of 140-199 mg/Dl, fasting glucose of 100-125 mg/dl, or hemoglobin A1c of 5.7-6.4%.

During 2011-2012, the prevalence of diabetes based on 2-hour postprandial glucose, fasting plasma glucose, or hemoglobin A1c was 14.3% for total diabetes (diagnosed and undiagnosed). Furthermore, the prevalence was 9.1% for diagnosed, 5.2% for undiagnosed, and 38% for pre-diabetes.

When compared to white individuals (11.3%), the age-standardized prevelance of diabetes was higher in Hispanics (22.6%, P less than .001), Asian (20% P=.007) and black individuals (21.8% P less than .001) individuals. Likewise, Hispanics and blacks tended to have higher body mass indices, compared to whites. Asians tended to have lower BMIs.

The age-standardized prevalence of diabetes increased from 9.8% to 12.4% during the 1988-19994 and 2011-2012 periods (P less than.001 trend). However, there was not much change in prevalence from 2007-2008 to 2011-2012 (12.5%to 12.4%).

When defining diabetes based on hemoglobin A1c, or fasting plasma glucose, the authors found fewer people with undiagnosed diabetes. For example, the prevalence was 12.3% for total diabetes with 3.1% undiagnosed and 9.2% diagnosed. Furthermore, 26.5% of the study subjects qualified as pre-diabetic based on these definitions.

The prevalence of diabetes significantly increased during the study time period in both sexes, all racial groups, education levels, incomes and ages."

Medications Used in Treatment:
1. Biguanides: metformin
2. Insulins: Humalog
3. Anabolic steroids for select males over age 18

*[Editor]PODCAST focus on  Children with Adult Onset Diabetes

Suggested Links
*Merck Manual
*Medscape

*[Editor]: See Breakthrough in Diabetes: Lecture Series

*[Editor]: With the fasting insulin, fasting glucose and hemoglobin A1c blood laboratory tests costing less than $20 (twenty dollars), every obese child and every adult should be screened for diabetes.

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