ARTICLE IN PRESS
PCD-343; No. of Pages 3
p r i m a r y c a r e d i a b e t e s x x x ( 2 0 1 3 ) xxx–xxx
Contents lists available at ScienceDirect
Primary Care Diabetes journal homepage: http://www.elsevier.com/locate/pcd
Brief report
Prevalence of undiagnosed diabetes among non-pregnant women of reproductive age in the United States, 1999–2010 Hilda Razzaghi a,b,∗ , Jessica Marcinkevage a,c , Cora Peterson a a
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA b Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA c Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA 30322, USA
a r t i c l e
i n f o
a b s t r a c t
Article history:
Undiagnosed diabetes has particularly harmful consequences among women of reproduc-
Received 16 July 2013
tive age. We assessed the prevalence of undiagnosed diabetes among non-pregnant women
Received in revised form
of reproductive age. In our data 30 women had A1C ≥ 6.5 and 28 had FPG ≥ 126 mg/dl val-
13 August 2013
ues suggesting approximately 300,000 women of reproductive age nationwide may have
Accepted 10 October 2013
undiagnosed diabetes.
Available online xxx
© 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
Keywords: Diabetes mellitus/diagnosis Diabetes mellitus/epidemiology Pregnancy complications
Undiagnosed diabetes affects an estimated 1.8–2.3% of the United States (US) adult population ≥20 years of age [1,2]. Undiagnosed diabetes can have particularly harmful consequences among women of reproductive age because pre-gestational diabetes mellitus (PGDM) is associated with a substantially increased risk of adverse birth outcomes in pregnant women [3–7]. Timely preconception care for women with PGDM can reduce the incidence of adverse birth outcomes, including preterm delivery, congenital malformations, and perinatal death [8,9]. We aimed to assess the prevalence of undiagnosed diabetes and those at high risk for developing
diabetes among non-pregnant women of reproductive age in the US. We applied the methods reported in Cowie et al. [1] essentially to a subset of the population examined in that analysis (the notable deviation is that our analysis included more years of data than Cowie et al.). Using data from the 1999–2010 National Health and Nutrition Examination Surveys (NHANES), we examined fasting plasma glucose (FPG) (assessed 1999–2010) and A1C (assessed 1999–2006) laboratory values among women age 15–44 with no self-reported diabetes diagnosis (based on whether, other than during pregnancy, a
Abbreviations: NHANES, National Health and Nutrition Examination Survey; PGDM, pre-gestational diabetes mellitus. Corresponding author at: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-86, Atlanta, GA 30333, USA. Tel.: +1 4044980126. E-mail address: [email protected] (H. Razzaghi). 1751-9918/$ – see front matter © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.pcd.2013.10.004 ∗
Please cite this article in press as: H. Razzaghi, et al., Prevalence of undiagnosed diabetes among non-pregnant women of reproductive age in the United States, 1999–2010, Prim. Care Diab. (2013), http://dx.doi.org/10.1016/j.pcd.2013.10.004
a
Notes: Includes women who self-reported no diabetes diagnosis and had recorded A1C/FPG laboratory values. Weighted percentages. b Approximately 2.5 million women of childbearing age may be at risk for diabetes. c Estimates suppressed because minimum degrees of freedom (12) for strata not met. d Approximately 7 million women of childbearing age may be at risk for diabetes.
438d (11.2%a ) 3886 (88.1%a ) 30c 284b (4.0%a ) 6567 (95.5%a )
At risk of diabetes 100–
PCD-343; No. of Pages 3
p r i m a r y c a r e d i a b e t e s x x x ( 2 0 1 3 ) xxx–xxx
Contents lists available at ScienceDirect
Primary Care Diabetes journal homepage: http://www.elsevier.com/locate/pcd
Brief report
Prevalence of undiagnosed diabetes among non-pregnant women of reproductive age in the United States, 1999–2010 Hilda Razzaghi a,b,∗ , Jessica Marcinkevage a,c , Cora Peterson a a
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA b Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA c Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA 30322, USA
a r t i c l e
i n f o
a b s t r a c t
Article history:
Undiagnosed diabetes has particularly harmful consequences among women of reproduc-
Received 16 July 2013
tive age. We assessed the prevalence of undiagnosed diabetes among non-pregnant women
Received in revised form
of reproductive age. In our data 30 women had A1C ≥ 6.5 and 28 had FPG ≥ 126 mg/dl val-
13 August 2013
ues suggesting approximately 300,000 women of reproductive age nationwide may have
Accepted 10 October 2013
undiagnosed diabetes.
Available online xxx
© 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
Keywords: Diabetes mellitus/diagnosis Diabetes mellitus/epidemiology Pregnancy complications
Undiagnosed diabetes affects an estimated 1.8–2.3% of the United States (US) adult population ≥20 years of age [1,2]. Undiagnosed diabetes can have particularly harmful consequences among women of reproductive age because pre-gestational diabetes mellitus (PGDM) is associated with a substantially increased risk of adverse birth outcomes in pregnant women [3–7]. Timely preconception care for women with PGDM can reduce the incidence of adverse birth outcomes, including preterm delivery, congenital malformations, and perinatal death [8,9]. We aimed to assess the prevalence of undiagnosed diabetes and those at high risk for developing
diabetes among non-pregnant women of reproductive age in the US. We applied the methods reported in Cowie et al. [1] essentially to a subset of the population examined in that analysis (the notable deviation is that our analysis included more years of data than Cowie et al.). Using data from the 1999–2010 National Health and Nutrition Examination Surveys (NHANES), we examined fasting plasma glucose (FPG) (assessed 1999–2010) and A1C (assessed 1999–2006) laboratory values among women age 15–44 with no self-reported diabetes diagnosis (based on whether, other than during pregnancy, a
Abbreviations: NHANES, National Health and Nutrition Examination Survey; PGDM, pre-gestational diabetes mellitus. Corresponding author at: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-86, Atlanta, GA 30333, USA. Tel.: +1 4044980126. E-mail address: [email protected] (H. Razzaghi). 1751-9918/$ – see front matter © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.pcd.2013.10.004 ∗
Please cite this article in press as: H. Razzaghi, et al., Prevalence of undiagnosed diabetes among non-pregnant women of reproductive age in the United States, 1999–2010, Prim. Care Diab. (2013), http://dx.doi.org/10.1016/j.pcd.2013.10.004
a
Notes: Includes women who self-reported no diabetes diagnosis and had recorded A1C/FPG laboratory values. Weighted percentages. b Approximately 2.5 million women of childbearing age may be at risk for diabetes. c Estimates suppressed because minimum degrees of freedom (12) for strata not met. d Approximately 7 million women of childbearing age may be at risk for diabetes.
438d (11.2%a ) 3886 (88.1%a ) 30c 284b (4.0%a ) 6567 (95.5%a )
At risk of diabetes 100–
