Racial/ethnic variation in prevalence estimates for United States prediabetes under alternative 2010 American Diabetes Association criteria: 1988-2008.

OBJECTIVE: To compare the racial/ethnic variation in United States prediabetes prevalence estimates for alternative prediabetes definitions currently approved by the American Diabetes Association (ADA) across 20 years and in detailed multivariate comparisons.
DESIGN: Using nationally representative National Health and Nutrition Examination Survey (NHANES) data from 1988-2008, we compared trends in the prevalence of impaired fasting glucose (IFG) and impaired glycated hemoglobin (IGH) for non-Hispanic Black, non-Hispanic White, and Mexican American/other Hispanic adults. Using NHANES 2005-2008, we compared prevalence by race/ethnicity in more detail for the three current ADA prediabetes definitions--IFG, IGH, and impaired glucose tolerance (IGT)--controlling for associated factors (education, income, weight, age, sex).
RESULTS: Prediabetes prevalence during the last 20 years was consistently significantly lower among non-Hispanic Blacks compared to non-Hispanic Whites when measured by IFG, but was significantly higher among non-Hispanic Blacks when measured by IGH. In adjusted models, non-Hispanic Blacks were significantly more likely than non-Hispanic Whites to have IGH (OR: 2.22; 95% CI: 1.33-3.70) and less likely to have IFG (OR: 0.46; 0.30-0.73) or IGT (OR: 0.35; 0.24-0.50), but Mexican American/other Hispanic rates did not differ significantly from non-Hispanic White rates. However, rates of prediabetes, when defined by any of three individual diagnostic criteria, were not statistically significantly different across groups (36.8% for non-Hispanic Whites, 36.0% AA, 37.3% Mexican American/other Hispanics).
CONCLUSIONS: National prediabetes prevalence estimates vary dramatically across racial/ethnic groups according to diagnostic method, though over 35% in all three racial/ethnic groups met at least one ADA diagnostic criteria for prediabetes.