1271-P: Associations of Combined Socioeconomic, Behavioral, and Metabolic Factors with Undiagnosed Diabetes and Prediabetes among Different Racial and Ethnic Groups

Abstract

Background: The study aimed to utilize socioeconomic, behavioral, and metabolic factors to classify adults without diagnosed diabetes into distinct cardiometabolic risk clusters. Racial/ethnic differences in the associations between clusters and undiagnosed diabetes and prediabetes were also explored. Methods: Data were obtained from the National Health and Nutrition Examination Survey (1999-2018). The k-prototypes clustering algorithm was used to identify clusters using 21 factors. Logistic regression was used to assess differences in the associations between clusters and undiagnosed diabetes or prediabetes by race/ethnicity. Results: Among 38,476 adults without diagnosed diabetes, we identified 3 clusters. Cluster 1 contained the highest proportions of alcohol consumers, had shortest sleep duration and poorest diet quality. Cluster 2 comprised healthy younger adults with lowest income, and lowest rates of healthcare access. Cluster 3 was mostly older males with chronic conditions; they were least physically active, and more likely to have healthcare access. Regardless of race/ethnicity, the adjusted undiagnosed diabetes risk was 14.9 times higher (95% CI 10.9, 20.2) in Cluster 3 and 3.7 times (95% CI 2.8, 4.8) higher in Cluster 1 (vs. Cluster 2). An elevated prediabetes risk was observed for Clusters 3 and 1 among non-Hispanic Whites, non-Hispanic Blacks, and Hispanic. Among other races/ethnicities, there were no significant differences in prediabetes risk between Clusters 3 and 2. Conclusion: Clustering analysis using a large number of socioeconomic, behavioral, and metabolic factors revealed three distinct groups of adults, with substantially different risks of undiagnosed diabetes and prediabetes. Incorporating socioeconomic and behavioral factors into traditional clinical risk measures may lead to better identification of subgroups at higher risk for undiagnosed diabetes and prediabetes. Disclosure Q.Ding: None. Y.Lu: None. J.Herrin: Consultant; Johnson & Johnson Medical Devices Companies. T.Zhang: None. D.G.Marrero: None. Funding Clifford B. Kinley Trust