Undiagnosed diabetes among Hispanic and white adults with elevated haemoglobin A1c levels.

Abstract

The aim of this study is to compare the frequency and correlates of undiagnosed diabetes between Hispanic and white American adults ages 20 and older with known diabetes or elevated HbA1c . Using 2007 to 2012 National Health and Nutrition Survey data, 1792 white and Hispanic Americans age 20 and older with known diabetes or elevated HbA1c (≥6.5%) were included in the analysis. Undiagnosed diabetes was defined as elevated HbA1c more than or equal to 6.5% without prior diabetes diagnosis. Covariates included demographics, health care access, and survey language. Hispanics were younger (54.92 vs 61.45y, p<.001) and had a higher rate of undiagnosed diabetes (28.2% vs 18.0%, p<.001) than their white counterparts. For Hispanics, those with undiagnosed diabetes had higher mean HbA1c than those with known diabetes (p=.03), but no significant difference was found between diagnosed and undiagnosed diabetes among whites. Covariates that decreased the odds of undiagnosed diabetes among Hispanic Americans included having a routine place to receive health care. For whites, covariates that decreased the odds of undiagnosed diabetes were a higher ratio of income to poverty level, having health insurance and having a routine place for health care. The high proportion of unknown diabetes among Hispanic Americans suggests the need for a culturally competent health campaign to improve community diabetes awareness. Emphasizing the importance of having a routine place of health care for regular health check-ups and expanded community resources for diabetes early detection and prevention among this population could decrease the burden of diabetes.