Obesity and Undiagnosed Diabetes in the United States
- Christina C. Wee, MD, MPH (cwee{at}bidmc.harvard.edu)1,
- Mary Beth Hamel, MD, MPH1,
- Annong Huang, MD, MPH, PhD1,
- Roger B. Davis, ScD1,
- Murray A. Mittleman, MD, DrPh2 and
- Ellen McCarthy, PhD, MPH1
- Division of General Medicine and Primary Care1, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
- Cardiovascular Epidemiology Research Unit2, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
Abstract
Objective: To study whether obese persons, who are at higher risk for diabetes and for disparities in care, are more likely to have undiagnosed diabetes.
Methods: Analysis of 5514 adult participants in the 1999-2004 National Health and Nutrition Examination Survey.
Results: Of the 9.8% (weighted sample) of participants who had diabetes based on fasting glucose levels and self-reported diagnosis, 28.1% were undiagnosed (estimated 5.2 million). The proportion undiagnosed was not significantly different among normal weight (22.2%), overweight (32.5%), or obese adults (27.4%). Nevertheless, obese adults comprise more than half the undiagnosed diabetes cases (2.7 million). Relative to normal weight adults, the adjusted odds ratio for having undiagnosed diabetes was 1.50 (0.73 – 3.08) in overweight and 1.37 (0.72 – 2.63) in obese adults.
Conclusions: Despite their higher underlying risk of diabetes and widespread clinical recognition of this higher risk, obese adults are no more likely to have their diabetes diagnosed than thinner adults.
Footnotes
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- Received September 24, 2007.
- Accepted May 18, 2008.
- Copyright © American Diabetes Association
