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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
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.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141163
DOI
10.1016/j.ahj.2015.07.024
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
강석민(Kang, Seok Min) ; 강은석(Kang, Eun Seok) ; 김규리(Kim, Gyuri) ; 안철우(Ahn, Chul Woo) ; 오재원(Oh, Jae Won) ; 이병완(Lee, Byung Wan) ; 이용호(Lee, Yong Ho) ; 이현철(Lee, Hyun Chul) ; 차봉수(Cha, Bong Soo)
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Full Text
http://www.sciencedirect.com/science/article/pii/S0002870315004640
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