Okkyung Kim1, Bruce Ovbiagele2, Natalie Valle3, Daniela Markovic4, Amytis Towfighi5. 1. Department of Neurology, University of Southern California, Los Angeles, California; Department of Neurology, Rancho Los Amigos National Rehabilitation Center, Downey, California; Department of Neurology, John Muir Medical Center, Walnut Creek, California. 2. Department of Neurology, Medical University of South Carolina, Charleston, South Carolina. 3. Department of Neurology, Rancho Los Amigos National Rehabilitation Center, Downey, California. 4. Department of Biomathematics, University of California, Los Angeles, California. 5. Department of Neurology, University of Southern California, Los Angeles, California; Department of Neurology, Rancho Los Amigos National Rehabilitation Center, Downey, California. Electronic address: towfighi@usc.edu.
Abstract
BACKGROUND AND PURPOSE: Up to 25% of the U.S. population has undiagnosed diabetes. Diabetes and stroke both disproportionately afflict race/ethnic minorities. We assessed race/ethnic differences in the prevalence of undiagnosed diabetes, prediabetes, and cardiometabolic risk profiles among stroke survivors in the United States. METHODS: The prevalence of diabetes and prediabetes among adults (≥20 years) with a self-reported history of stroke was assessed using the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2010. Cardiometabolic risk factors across race/ethnic groups were compared using linear and logistic regression before and after adjusting for covariates. RESULTS: From 1999 to 2010, 1070 individuals who participated in NHANES had a self-reported history of stroke. Among stroke survivors without a formal diagnosis of diabetes and prediabetes, 233 (32%) had undiagnosed prediabetes and 27 (3.7%) had undiagnosed diabetes. The prevalence of undiagnosed diabetes and prediabetes was the highest among non-Hispanic (NH) blacks (8% and 38%) compared with Mexican Americans (4% and 26%) and NH whites (3% and 32%). Compared with NH whites, NH blacks were significantly younger, more likely to take antihypertensive medications, more likely to smoke, and have poorly controlled diabetes. NH blacks were twice as likely as NH whites to have poorly controlled blood pressure, after adjustment for sociodemographic and vascular risk factors. CONCLUSION: In the United States, NH black stroke survivors have the highest rates of undiagnosed diabetes and prediabetes, and have poorer cardiometabolic risk factor control than their NH white counterparts.
BACKGROUND AND PURPOSE: Up to 25% of the U.S. population has undiagnosed diabetes. Diabetes and stroke both disproportionately afflict race/ethnic minorities. We assessed race/ethnic differences in the prevalence of undiagnosed diabetes, prediabetes, and cardiometabolic risk profiles among stroke survivors in the United States. METHODS: The prevalence of diabetes and prediabetes among adults (≥20 years) with a self-reported history of stroke was assessed using the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2010. Cardiometabolic risk factors across race/ethnic groups were compared using linear and logistic regression before and after adjusting for covariates. RESULTS: From 1999 to 2010, 1070 individuals who participated in NHANES had a self-reported history of stroke. Among stroke survivors without a formal diagnosis of diabetes and prediabetes, 233 (32%) had undiagnosed prediabetes and 27 (3.7%) had undiagnosed diabetes. The prevalence of undiagnosed diabetes and prediabetes was the highest among non-Hispanic (NH) blacks (8% and 38%) compared with Mexican Americans (4% and 26%) and NH whites (3% and 32%). Compared with NH whites, NH blacks were significantly younger, more likely to take antihypertensive medications, more likely to smoke, and have poorly controlled diabetes. NH blacks were twice as likely as NH whites to have poorly controlled blood pressure, after adjustment for sociodemographic and vascular risk factors. CONCLUSION: In the United States, NH black stroke survivors have the highest rates of undiagnosed diabetes and prediabetes, and have poorer cardiometabolic risk factor control than their NH white counterparts.
Authors: Panagis Galiatsatos; Krista A Haapanen; Katie Nelson; Ashley Park; Hasmin Sherwin; Mariah Robertson; Kerry Sheets; W Daniel Hale Journal: J Relig Health Date: 2018-10
Authors: Amytis Towfighi; Eric M Cheng; Monica Ayala-Rivera; Frances Barry; Heather McCreath; David A Ganz; Martin L Lee; Nerses Sanossian; Bijal Mehta; Tara Dutta; Ali Razmara; Robert Bryg; Shlee S Song; Phyllis Willis; Shinyi Wu; Magaly Ramirez; Adam Richards; Nicholas Jackson; Jeremy Wacksman; Brian Mittman; Jamie Tran; Renee R Johnson; Chris Ediss; Theresa Sivers-Teixeira; Betty Shaby; Ana L Montoya; Marilyn Corrales; Elizabeth Mojarro-Huang; Marissa Castro; Patricia Gomez; Cynthia Muñoz; Diamond Garcia; Lilian Moreno; Maura Fernandez; Enrique Lopez; Sarah Valdez; Hilary R Haber; Valerie A Hill; Neal M Rao; Beatrice Martinez; Lillie Hudson; Natalie P Valle; Barbara G Vickrey Journal: JAMA Netw Open Date: 2021-02-01