Prevalence Of Undiagnosed Type Research Articles

Evaluation of Diabetes Risk Score Tool for Detecting Undiagnosed Type 2 Diabetes Mellitus in Referral Clinics at Primary Health Care Centers in Sudan: a Cross-sectional Study

INTRODUCTION: The prevalence of diabetes in Sudan is increasing, but suitable risk assessment and screening tools to identify at-risk individuals are lacking. OBJECTIVE: To evaluate the Diabetes Risk Score (DRS) tool for detecting undiagnosed type 2 diabetes mellitus. METHODS: In this cross-sectional study, 214 individuals were recruited from primary health care referral centers in Khartoum State. Attendees were interviewed to fill out the DRS questionnaire. Random blood glucose and glycosylated hemoglobin (HbA1c) were tested. Descriptive statistics and sensitivity analyses were used to test the applicability of the DRS in Sudan. RESULTS: The prevalence of undiagnosed Type 2 diabetes was found to be 14%. Regarding blood tests, random blood glucose was normal in 93% of the participants (cutoff: ≤140 mg/dl). The HbA1c result was normal in 86% of the participants (cutoff: < 6.4%). The DRS was high in 40.2% (cutoff: ≥33), while 59.8% were considered to have moderate to low risk. The DRS had a sensitivity of 83.33% and a specificity of 66.85%. The positive and negative predictive values were 29.07% and 96.09%, respectively. The area under the curve (AUC) for detecting undiagnosed Type 2 diabetes was 0.751 (95% confidence interval: 0.662-0.840). CONCLUSION: The DRS tool was found to be applicable with reference to the HbA1c test for predicting undiagnosed Type 2 diabetes.

Evaluation of Diabetes Risk Score Tool for Detecting Undiagnosed Type 2 Diabetes Mellitus in Referral Clinics at Primary Health Care Centers in Sudan

INTRODUCTION: The prevalence of diabetes in Sudan is increasing, but suitable risk assessment and screening tools to identify at-risk individuals are lacking. OBJECTIVE: To evaluate the Diabetes Risk Score (DRS) tool for detecting undiagnosed type 2 diabetes mellitus. METHODS: In this cross-sectional study, 214 individuals were recruited from primary health care referral centers in Khartoum State. Attendees were interviewed to fill out the DRS questionnaire. Random blood glucose and glycosylated hemoglobin (HbA1c) were tested. Descriptive statistics and sensitivity analyses were used to test the applicability of the DRS in Sudan. RESULTS: The prevalence of undiagnosed Type 2 diabetes was found to be 14%. Regarding blood tests, random blood glucose was normal in 93% of the participants (cutoff: ≤140 mg/dl). The HbA1c result was normal in 86% of the participants (cutoff: < 6.4%). The DRS was high in 40.2% (cutoff: ≥33), while 59.8% were considered to have moderate to low risk. The DRS had a sensitivity of 83.33% and a specificity of 66.85%. The positive and negative predictive values were 29.07% and 96.09%, respectively. The area under the curve (AUC) for detecting undiagnosed Type 2 diabetes was 0.751 (95% confidence interval: 0.662-0.840). CONCLUSION: The DRS tool was found to be applicable with reference to the HbA1c test for predicting undiagnosed Type 2 diabetes.

Examining if the relationship between BMI and incident type 2 diabetes among middle-older aged adults varies by race/ethnicity: evidence from the Multi-Ethnic Study of Atherosclerosis (MESA).

Disparities persist on the prevalence of undiagnosed type 2 diabetes in racial/ethnic minorities in the USA. This study evaluated the association between BMI and incident type 2 diabetes risk by racial/ethnic group, to determine whether BMI and presence of type 2 diabetes risk factors may help clinicians better target type 2 diabetes screening. This prospective cohort analysis included 5659 adults free of type 2 diabetes at baseline from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based cohort (2000-2011). BMI was measured at baseline and time-updated at subsequent visits. Incident type 2 diabetes was defined as fasting glucose ≥7.0 mmol/l, or use of any diabetes medications. The mean (sd) age was 62 (10)years and 42% of participants were white, 26% African American, 20% Hispanic and 12% Chinese American. During follow-up, 696 (12%) new type 2 diabetes cases were observed. In age- and sex-adjusted models, in the presence of one or more type 2 diabetes risk factors (the most common scenario), a 10% risk of incident type 2 diabetes was observed at a BMI of 21.7kg/m2 [95% confidence interval (CI) 20.1 to 22.8] in Chinese Americans, 23.8kg/m2 (22.7 to 24.9) in Hispanics, 24.7kg/m2 (23.7 to 25.6) in African Americans and 26.2kg/m2 (25.1 to 26.9) in white participants. This study supports including BMI and presence of type 2 diabetes risk factors as action points for clinicians to prioritize which adults aged ≥45years should be screened. The application of race/ethnicity-specific BMI thresholds may reduce the disparity of undiagnosed type 2 diabetes observed in minority groups.

Prevalence of Undiagnosed Diabetes and Prediabetes in the Dental Setting: A Systematic Review and Meta-Analysis.

Background With the close link between diabetes mellitus (DM) and periodontal disease (PD), dentists have an unrealized opportunity to make a chance discovery of a patient's medical condition. Unlike in the medical setting, information on the point of care (PoC) and opportunistic screening for DM in the dental setting is limited. To make a reliable estimate on the prevalence of undiagnosed type 2 diabetes mellitus (T2DM) and prediabetes among dental patients in the dental setting and to assist healthcare planners in making an informed decision, information on the disease frequency and strategies employed to address this issue is of paramount importance. Objectives To summarize the data on the prevalence of undiagnosed T2DM and prediabetes amongst dental patients and further explore the effectiveness of the PoC screening and its implication for use in the dental setting. Methods A MEDLINE-PubMed, EMBASE, Web of Science, and Cochrane Library search was conducted with no time specification. Information on study characteristics and diagnostic parameters was retrieved for meta-analysis. All the studies were assessed for methodological quality using the QUADAS-2 tool. Proportions were presented in tables and forest plots. All statistical analysis was performed using the MedCalc software. Results Nine studies met the inclusion criteria. The proportion of dental patients identified to be at a risk of hyperglycaemia with the PoC screening using random blood glucose (RBG) and HbA1 was 32.47% and 40.10%, whilst the estimated proportion with undiagnosed T2DM and prediabetes was identified as 11.23% and 47.38%. Conclusion A significant proportion of dental patients can be identified as undiagnosed T2DM and prediabetes. Targeted opportunistic screening is a feasible approach and can help reduce the prevalence of undiagnosed T2DM and prediabetes.

A Nonparametric Bootstrap Confidence Interval for the Prevalence of Undiagnosed Type 2 Diabetes Mellitus in Hamadan, West of Iran.

The prevalence of type 2 diabetes mellitus (T2DM) is increasing in Iran. This study determined the prevalence of undiagnosed type 2 diabetes mellitus in apparently normal individuals in Hamadan, west of Iran. A cross-sectional study. A sample of 106 apparently normal volunteers aged 18 yr and more were enrolled, and T2DM was diagnosed using hemoglobin A1c (HbA1c) levels from 2015-2016. The nonparametric bootstrap method was used to eliminate the undesirable effect of small sample size on the estimation of standard error of multiple logistic regression coefficients and confidence interval for the prevalence of undiagnosed T2DM. Overall, 23 (21.69%) were male. The mean (±sd) age of the participants was 43.76 ±14.01 year. In 78.3% of individuals, HbA1c level was within normal range (<5.7), 13.21% was in the range of 5.7-6.4 (undiagnosed pre-T2DM), and 8.49% was ≥6.5 (undiagnosed T2DM). Multiple logistic regression gave the characteristic distribution of volunteers such as sedentary hour (P=0.001), family history of diabetes (P=0.001), smoking (P=0.002), and age (P=0.012) had the odds on the significant effect on undiagnosed T2DM. The prevalence of undiagnosed T2DM among apparently normal individuals in Hamadan was relatively high. Addition to age, factors such as sedentary, exposure to smoking and having a history of diabetes in family can be a prognosis for undiagnosed T2DM in apparently normal individuals.

Prevalence of Undiagnosed Type 2 Diabetes Mellitus and Its Associated Factors Among the Malaysian Population: The 2015 National Health and Morbidity Survey, Malaysia

BACKGROUND: The prevalence of diabetes has increased dramatically in the last decade. Compounding the problem are undiagnosed cases of type 2 diabetes mellitus. These respondents are those who do not know that they have the disease. Undiagnosed cases have substantial implications as they are at more risk to develope fatal complications. This study aims to determine the prevalence of undiagnosed T2DM and to identify its associated factors in Malaysia.METHODS: A nationwide cross-sectional study was conducted involving 19,935 respondents. Two-stage stratified sampling design was used to select a representative sample of the Malaysian adult population. Face-to-face interviews using structured, validated questionnaires were used to obtain data from the respondents. Respondents who claimed that they were not diagnosed with diabetes before were asked to undergo a finger-prick test.RESULTS: The overall prevalence of T2DM was 17.5% while the prevalence of undiagnosed T2DM was 9.2% (n=2103). Respondents aged 60 years old &amp;amp; above had the highest percentage of undiagnosed T2DM at about 13.6 %, followed by those with no formal educational at 12.9%, among Indians were 11.9%, among female at 9.2%, among non-working citizen at 9.8%, widowed/divorced (12.0%), smokers (9.5%), obesity (13.6%) and hypertensive (12.8%). Multivariable analyses revealed that age group, ethnicity, education level, marital status, obesity and hypertensive were more likely to have undiagnosed T2DM.CONCLUSION: This study showed a high prevalence of undiagnosed T2DM in Malaysia. Factors associated with undiagnosed diabetes mellitus were obesity, age, ethnicity, educational level and hypertension. Screening is essential among adults aged 30 to 60 year old to enable early intervention and prevent development of serious complications of this disease.

Prevalence of undiagnosed type 2 diabetes in patients admitted with acute coronary syndrome: the utility of easily reproducible screening methods

BackgroundDespite the recognition of the importance of diagnosing dysglycaemia in patients with acute coronary syndrome (ACS) there remains a lack of consensus on the best screening modality. Our primary aims were to determine the prevalence of undiagnosed dysglycaemia and to compare the OGTT and HbA1c criteria for diagnosis of T2DM in patients admitted to hospital with ACS at baseline and at 3-months. We also aimed to investigate the role of a screening algorithm and a predictor score to define glucose tolerance in this population.MethodsA prospective study in which patients admitted with ACS to two UK teaching hospitals were assessed at baseline and 3 months follow-up.ResultsThe prevalence of diabetes at baseline was 20% and 16% based on OGTT and HbA1c criteria respectively. Forty three (43) % of the patients with T2DM based on OGTT would have been missed by the HbA1c criteria at baseline. Our screening algorithm identified 87% of patients with T2DM diagnosed with OGTT. Diabetes Predictor score had better sensitivity (>80%) and negative predictive value (>90%) compared to HbA1c criteria. Two thirds of participants with IGS and a third with T2DM changed their glycaemic status at 3 months.ConclusionsOnly 48% of the patients admitted with ACS had normo-glycaemia based on OGTT. OGTT and HbA1c identified two different populations of patients with dysglycaemia with the HbA1c criteria missing almost half the patients with T2DM based on OGTT. Compared to HbA1c criteria our diabetes algorithm and diabetes predictor score had a better correlation with OGTT criteria.

The Prevalence of Undiagnosed Type 2 Diabetes On The General Medicine Ward

The Prevalence of Undiagnosed Type 2 Diabetes On The General Medicine Ward

Fasting plasma glucose as initial screening for diabetes and prediabetes in irish adults: The Diabetes Mellitus and Vascular health initiative (DMVhi).

ObjectiveType 2 diabetes has a long pre clinical asymptomatic phase. Early detection may delay or arrest disease progression. The Diabetes Mellitus and Vascular health initiative (DMVhi) was initiated as a prospective longitudinal cohort study on the prevalence of undiagnosed Type 2 diabetes and prediabetes, diabetes risk and cardiovascular risk in a cohort of Irish adults aged 45-75 years.Research Design and MethodsMembers of the largest Irish private health insurance provider aged 45 to 75 years were invited to participate in the study. Exclusion criteria: already diagnosed with diabetes or taking oral hypoglycaemic agents. Participants completed a detailed medical questionnaire, had weight, height, waist and hip circumference and blood pressure measured. Fasting blood samples were taken for fasting plasma glucose (FPG). Those with FPG in the impaired fasting glucose (IFG) range had a 75gm oral glucose tolerance test performed.Results122,531 subjects were invited to participate. 29,144 (24%) completed the study. The prevalence of undiagnosed diabetes was 1.8%, of impaired fasting glucose (IFG) was 7.1% and of impaired glucose tolerance (IGT) was 2.9%. Dysglycaemia increased among those aged 45-54, 55-64 and 65-75 years in both males (10.6%, 18.5%, 21.7% respectively) and females (4.3%, 8.6%, 10.9% respectively). Undiagnosed T2D, IFG and IGT were all associated with gender, age, blood pressure, BMI, abdominal obesity, family history of diabetes and triglyceride levels. Using FPG as initial screening may underestimate the prevalence of T2D in the study population.ConclusionsThis study is the largest screening study for diabetes and prediabetes in the Irish population. Follow up of this cohort will provide data on progression to diabetes and on cardiovascular outcomes.

Prevalence of Prediabetes and Undiagnosed Diabetes in Canada (2007-2011) According to Fasting Plasma Glucose and HbA1c Screening Criteria.

To provide the first population-based estimates of prediabetes and undiagnosed type 2 diabetes prevalence in Canada. We combined two fasting subsamples of the Canadian Health Measures Survey, which were restricted to nonpregnant adults ≥20 years of age (N = 3,494). Undiagnosed diabetes was defined as not having self-reported type 2 diabetes but having blood glucose measures that met Canadian guidelines (i.e., fasting plasma glucose [FPG] level of ≥7.0 mmol/L or hemoglobin A1c [HbA1c] level of ≥6.5% [≥48 mmol/mol]). Prediabetes was defined as an FPG level of ≥6.1 and <7.0 mmol/L or an HbA1c level of ≥6.0% and <6.5% (≥42 and <48 mmol/mol). All estimates were weighted using survey sampling weights. CIs were calculated with the bootstrap method. According to FPG levels, the prevalence of undiagnosed type 2 diabetes in Canadian adults was 1.13% (95% CI 0.79, 1.62), contributing to ∼20% of total type 2 diabetes prevalence (5.62 [95% CI 4.52, 6.95]). Compared with FPG levels, the undiagnosed prevalence was greater using HbA1c level as a criterion (3.09% [95% CI 1.97, 4.81]), ∼41% of the total number of cases of diabetes (7.55 [95% CI 5.98, 9.49]). The HbA1c-only criterion resulted in a threefold increase in prediabetes prevalence overall and a sixfold increase among females (FPG 2.22%, HbA1c 13.31%). Screening based on FPG only identified older undiagnosed case patients, with a mean age of 58.7 years (95% CI 59.9, 63.4). Similarly, using HbA1c identified younger individuals with prediabetes, with reduced BMI and waist circumference compared with FPG levels. In this first study of a nationally representative sample with biospecimen measures, we found that the prevalence of undiagnosed type 2 diabetes and prediabetes was significantly higher using HbA1c levels compared with FPG levels. Further evaluation is needed to fully assess the impact of using the HbA1c criterion.

Prevalence of Undiagnosed Type 2 Diabetes &amp; Pre- Diabetes Conditions in Patients Visiting Dental Clinics

Prevalence of Undiagnosed Type 2 Diabetes &amp; Pre- Diabetes Conditions in Patients Visiting Dental Clinics

Period prevalence of abnormal glucose tolerance and cardiovascular risk factors among obese children attending an obesity centre in Italy

Background and aimSeveral reports have described an increasing prevalence and incidence of type 2 diabetes among children. Limited information is available about the prevalence of impaired glucose tolerance (IGT) and type 2 diabetes in obese children, particularly in Europe. The aim of this study was to examine the prevalence of glucose intolerance and other cardiovascular risk factors in obese children over a 24-year period. Methods and resultsThe study population consisted of 1376 consecutive subjects who attended a national centre for the study of obesity between 1979 and 2002. Subjects were divided into three successive 8-year cohorts: cohort 1 (period 1979–1986, n=453, male: 39%), cohort 2 (period 1987–1994, n=409, male: 46%), cohort 3 (period 1995–2002, n=514, male: 48%). All subjects underwent an oral glucose tolerance test. Lipids, blood pressure, uric acid, C-reactive protein (CRP), fasting insulin and birth weight were recorded. Insulin resistance was measured by homeostasis model assessment (HOMA-IR). The degree of obesity was higher in the more recent cohorts (standard deviation score of body mass index: 3.3±0.04 vs. 3.7±0.04 vs. 3.8±0.03, P<0.0001). The proportion of subjects with glucose intolerance was lower in the last two cohorts compared with the first one (11.2% vs. 3.9% vs. 6.0%, P<0.0001). This was predominantly due to changes in the frequency of IGT (9.1% vs. 3.2% vs. 5.4%, P<0.001 in cohorts 1, 2 and 3, respectively) while the prevalence of undiagnosed type 2 diabetes and impaired fasting glucose was similar in the three cohorts (0.9% vs. 0% vs. 0.2% and 1.3% vs. 0.7% vs. 0.4%, respectively). After adjustment for differences in age, sex, pubertal status and birth weight the levels of fasting insulin, HOMA-IR, total cholesterol, triglycerides and blood pressure, were significantly lower in cohorts 2 and 3 than in cohort 1 while CRP and uric acid were higher in the last two cohorts. ConclusionOver a recent period spanning 24years, the degree of obesity has risen but the prevalence of glucose intolerance has fallen in obese children admitted to an obesity centre. This was accompanied by an improvement in traditional but a worsening in non-traditional risk factors for cardiovascular disease.

Prevalence of undiagnosed Type 2 diabetes and impaired fasting glucose in older B ritish men and women

To estimate the prevalence of undiagnosed diabetes and impaired fasting glucose in older British men and women, using the 1999 World Health Organization (WHO) thresholds based on fasting glucose measurements. Participants in the British Regional Heart Study and the British Women's Heart and Health Study were selected from one socially representative general practice in 24 British towns. Included in this analysis were 3736 men and 3642 women aged 60-79 years (predominantly white), who provided a single fasting blood sample at a clinical examination between 1998 and 2001, and who had no previous diagnosis of diabetes. Two hundred and eleven men (5.7%) and 190 women (5.2%) had a fasting blood glucose level consistent with the WHO threshold for a diagnosis of diabetes (> or = 7.0 mmol/l), whilst a further 667 men (17.9%) and 642 women (17.6%) had impaired fasting glucose levels (6.1 < or = 7 mmol/l). When analyses were restricted to subjects who had fasted for at least 8 h, and whose blood sample was taken before 12.00 h, the predicted prevalence of undiagnosed diabetes (based on two separate measurements) was 6.7% in men and 6.0% in women. The predicted prevalence of impaired fasting glucose (based on two separate measurements) was approximately 20% in both sexes. More than one-fifth of older white British men and women have either undiagnosed diabetes or impaired fasting glucose according to new WHO criteria. Strategies for the primary and secondary prevention of Type 2 diabetes among older individuals are urgently needed.

Relationships of fasting and postload glucose levels to sex and alcohol consumption. Are American Diabetes Association criteria biased against detection of diabetes in women?

To compare, in men and women, the prevalence of undiagnosed type 2 diabetes assessed using criteria from the American Diabetes Association (ADA) and the World Health Organization (WHO) and to investigate risk factors associated with fasting and 2-h postload plasma glucose. Data from two companion surveys of Europeans, South Asians, and Afro-Caribbeans in west London were used. A total of 4,367 men and women aged 40-64 years who were not known to have diabetes underwent an oral glucose tolerance test after an overnight fast. The prevalence of undiagnosed diabetes was estimated using the ADA (fasting plasma glucose > or = 7.0 mmol/l) and WHO (2-h postload glucose > or = 11.1 mmol/l) criteria for epidemiologic studies. The association of body fat and usual alcohol intake with plasma glucose and diabetes prevalence was assessed. Compared with the WHO criterion, the ADA criterion gave a higher prevalence of diabetes in men (6.4 vs. 4.7%) but a lower prevalence in women (3.3 vs. 4.2%). In Afro-Caribbeans, the sex difference in diabetes prevalence was reversed. Women had significantly lower fasting glucose than men despite higher 2-h glucose levels. Alcohol intake was positively associated with fasting glucose in men and women but not with 2-h glucose levels. The new ADA criterion, based on fasting glucose alone, does not take account of sex differences in metabolic response to fasting or possible artifactual effects on fasting glucose. With the ADA criterion, alcohol intake was a significant risk factor for diabetes in our study population; this was not the case with the WHO criterion.