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Undiagnosed diabetes is prevalent in younger adults and associated with a higher risk cardiometabolic profile compared to diagnosed diabetes

Authors
 Yong-ho Lee  ;  Ehrin J. Armstrong  ;  Gyuri Kim  ;  Jaewon Oh  ;  Seok-Min Kang  ;  Byung-Wan Lee  ;  Chul Woo Ahn  ;  Bong Soo Cha  ;  Hyun Chul Lee  ;  Christos S. Mantzoros  ;  Eun Seok Kang 
Citation
 AMERICAN HEART JOURNAL, Vol.170(4) : 760-769, 2015 
Journal Title
 AMERICAN HEART JOURNAL 
ISSN
 0002-8703 
Issue Date
2015
MeSH
Adult ; Blood Glucose/metabolism ; Cardiovascular Diseases/epidemiology* ; Cardiovascular Diseases/etiology ; Cross-Sectional Studies ; Diabetes Mellitus/blood ; Diabetes Mellitus/diagnosis* ; Diabetes Mellitus/epidemiology* ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Young Adult
Abstract
BACKGROUND: A substantial percentage of patients have undiagnosed diabetes. We investigated the demographic characteristics and cardiometabolic profiles of subjects with undiagnosed diabetes. METHODS: A cross-sectional study with nationally representative samples of 25490 subjects aged ≥ 20 years from the KHNANES 2008 to 2011, which applied a complex, multistage, probability proportional to size sampling design. Subjects were categorized as having normal glucose (n = 16880), impaired fasting glucose (n = 5771), undiagnosed diabetes (n = 713), or diagnosed diabetes (n = 2126). Hyper low-density lipoprotein cholesterolemia was individually evaluated by the 2004 Adult Treatment Panel III guidelines and predicted risk of cardiovascular disease was estimated from the Framingham model. RESULTS: Among overall subjects with diabetes, the prevalence of undiagnosed diabetes was markedly increased in younger adults compared to older adults (49% in diabetic subjects <50 years vs 23% in diabetic subjects ≥50 years, P < .001), suggesting significant discrepancies in age-based screening. Patients with undiagnosed diabetes were also more likely to have undiagnosed or uncontrolled hypertension and hyper-low-density lipoprotein cholesterolemia. Individuals with undiagnosed diabetes had a significantly higher predicted 10-year Framingham cardiovascular disease risk than those with diagnosed diabetes (11% vs 8% in <50 years, 33% vs 30% in ≥50 years; both P < .001). Patients with undiagnosed diabetes were also more likely to have multiple cardiovascular risk factors including obesity, smoking and uncontrolled hypertension. CONCLUSIONS: People with undiagnosed diabetes have a higher predicted risk for cardiovascular disease compared to those with diagnosed diabetes. Intensive screening for diabetes in younger adults should be stressed in public healthcare to reduce the burden of modifiable cardiometabolic risk among individuals with undiagnosed diabetes.
Full Text
http://www.sciencedirect.com/science/article/pii/S0002870315004640
DOI
10.1016/j.ahj.2015.07.024
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Gyuri(김규리)
Ahn, Chul Woo(안철우) ORCID logo https://orcid.org/0000-0003-3733-7486
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Lee, Hyun Chul(이현철)
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141163
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