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Detection of Prediabetes and Undiagnosed Type 2 Diabetes: A Large Population-Based Study

      Abstract

      Objective

      Prediabetes and undiagnosed diabetes have been commonly ignored. We aimed to investigate the prevalence of prediabetes and undiagnosed type 2 diabetes mellitus, and to verify the hypothesis that vascular risk factors (VRFs) may indicate prediabetes and undiagnosed type 2 diabetes.

      Methods

      A total of 7567 adults, who were 20 to 79 years of age, and living in Tianjin, China, participated in this study. Type 2 diabetes was assessed based on medical history, hypoglycemic drugs use, fasting plasma glucose level ≥7.0 mmol/L, or postprandial 2-hour plasma glucose level ≥11.1 mmol/L. Undiagnosed type 2 diabetes was defined among subjects with type 2 diabetes when neither a medical history of diabetes nor hypoglycemic drugs use was present. Prediabetes was ascertained as fasting plasma glucose level of 6.1 to 6.9 mmol/L, or postprandial 2-hour plasma glucose level of 7.8 to 11.0 mmol/L (WHO 1999) among diabetes-free participants. Data were analyzed using multinomial logistic regression with adjustment for potential confounders.

      Results

      Of all participants, 655 (8.7%) had prediabetes, and 721 (9.5%) were patients with type 2 diabetes, including 321 (4.2%) undiagnosed type 2 diabetes accounting for 44.5% patients with diabetes. The prevalence of prediabetes and undiagnosed type 2 diabetes increased with age, and was higher in women than in men. In a fully adjusted multinomial logistic regression model, hypertension, overweight, obesity, central obesity, and family history of diabetes were significantly associated with prediabetes and undiagnosed diabetes, whereas physical inactivity was independently related to undiagnosed diabetes.

      Conclusion

      The prevalence of prediabetes and undiagnosed diabetes is approximately 13%, and almost 45% of patients with diabetes are undiagnosed. VRFs, such as hypertension, high adiposity, and family history of diabetes can be indicators for detecting prediabetes and undiagnosed diabetes.

      Résumé

      Objectif

      Le prédiabète et le diabète non diagnostiqué ont souvent été ignorés. Notre objectif était d’évaluer la prévalence du prédiabète et du diabète sucré de type 2 non diagnostiqué, et de vérifier l’hypothèse selon laquelle les facteurs de risque vasculaire (FRV) peuvent indiquer le prédiabète et le diabète de type 2 non diagnostiqué.

      Méthodes

      Un total de 7567 adultes qui étaient âgés de 20 à 79 ans et vivaient à Tianjin en Chine ont participé à cette étude. Le diabète de type 2 a été évalué en fonction des antécédents médicaux, de l’utilisation de médicaments hypoglycémiants, d’une glycémie à jeun ≥ 7,0 mmol/l ou d’une glycémie postprandiale à 2 heures ≥ 11,1 mmol/l. Le diabète de type 2 non diagnostiqué a été défini chez des sujets ayant un diabète de type 2 lorsque ni des antécédents médicaux de diabète ni l’utilisation de médicaments hypoglycémiants n’étaient présents. Le prédiabète était certain lorsque la glycémie à jeun était de 6,1 à 6,9 mmol/l ou la glycémie postprandiale à 2 heures était de 7,8 à 11,0 mmol/l (OMS, 1999) chez les participants n’ayant pas de diabète. Les données ont été analysées en utilisant la régression logistique multinomiale par l’ajustement des facteurs de confusion potentiels.

      Résultats

      Parmi tous les participants, 655 (8,7 %) avaient un prédiabète, et 721 (9,5 %) étaient des patients ayant un diabète de type 2, dont 321 (4,2 %) cas de diabète de type 2 non diagnostiqué représentant 44,5 % de patients ayant le diabète. La prévalence du prédiabète et du diabète de type 2 non diagnostiqué augmentait avec l’âge, et était plus élevée chez les femmes que chez les hommes. Dans le modèle de régression logistique multinomiale complètement ajustée, l’hypertension, la surcharge pondérale, l’obésité, l’obésité centrale et les antécédents familiaux de diabète ont été significativement associés au prédiabète et au diabète non diagnostiqué, alors que l’inactivité physique a été indépendamment reliée au diabète non diagnostiqué.

      Conclusion

      La prévalence du prédiabète et du diabète non diagnostiqué est approximativement de 13 %, et presque 45 % des patients ayant le diabète n’ont pas reçu de diagnostic. Les FRV, comme l’hypertension, l’adiposité élevée et les antécédents familiaux de diabète peuvent être des indicateurs dans la détection du prédiabète et du diabète non diagnostiqué.

      Keywords

      Mots clés

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