Marit Eika Jørgensen1,2, Christina Ellervik3,4, Ola Ekholm2, Nanna Borup Johansen5, Bendix Carstensen1. 1. Steno Diabetes Center Copenhagen, Gentofte, Denmark. 2. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 3. Division of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 4. Department of Production, Research, and Innovation; Region Zealand, Sorø, Denmark. 5. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Abstract
Background: Up-to-date information on undiagnosed type 2 diabetes and prediabetes based on current diagnostic criteria is lacking. The study aimed to model the total numbers of people with undiagnosed type 2 diabetes and prediabetes in Denmark based on existing population-based surveys. Methods: Two population-based Danish studies with information on HbA1c, date of examination, gender, age and known type 2 diabetes were identified: the Danish General Suburban Population Study, n = 21,205, and the Danish Health Examination Survey, n = 18,065. The prevalence of known, undiagnosed and pre-diabetes were estimated in the Danish General Suburban Population Study, and population-level age-specific prevalence of known type 2 diabetes was estimated from national registers. The Danish Health Examination Survey was included for sensitivity analysis. Combining estimates of the survey participation rate among known type 2 diabetes patients with known overall participation rates from the studies allowed for the correction of survey prevalence to plausible population-level estimates of age- and gender-specific prevalence. Results: The prevalence of known, undiagnosed and pre-diabetes was highest among men, increasing with age with a peak at age 70. Applying the survey-based prevalence to the entire Danish population, the estimated number (May 2011) with undiagnosed type 2 diabetes was 60,681, corresponding to 24% of all type 2 diabetes cases, and 292,715 had prediabetes, about 50% more than the total type 2 diabetes population. Conclusions: Estimates of undiagnosed type 2 diabetes and prediabetes are dramatically lower than reported in previous studies (60,681 vs 200,000 and 292,715 vs 750,000); however, whether this reflects a true decrease in incidence or the change to HbA1c-based diagnostic criteria is not clear.
Background: Up-to-date information on undiagnosed type 2 diabetes and prediabetes based on current diagnostic criteria is lacking. The study aimed to model the total numbers of people with undiagnosed type 2 diabetes and prediabetes in Denmark based on existing population-based surveys. Methods: Two population-based Danish studies with information on HbA1c, date of examination, gender, age and known type 2 diabetes were identified: the Danish General Suburban Population Study, n = 21,205, and the Danish Health Examination Survey, n = 18,065. The prevalence of known, undiagnosed and pre-diabetes were estimated in the Danish General Suburban Population Study, and population-level age-specific prevalence of known type 2 diabetes was estimated from national registers. The Danish Health Examination Survey was included for sensitivity analysis. Combining estimates of the survey participation rate among known type 2 diabetespatients with known overall participation rates from the studies allowed for the correction of survey prevalence to plausible population-level estimates of age- and gender-specific prevalence. Results: The prevalence of known, undiagnosed and pre-diabetes was highest among men, increasing with age with a peak at age 70. Applying the survey-based prevalence to the entire Danish population, the estimated number (May 2011) with undiagnosed type 2 diabetes was 60,681, corresponding to 24% of all type 2 diabetes cases, and 292,715 had prediabetes, about 50% more than the total type 2 diabetes population. Conclusions: Estimates of undiagnosed type 2 diabetes and prediabetes are dramatically lower than reported in previous studies (60,681 vs 200,000 and 292,715 vs 750,000); however, whether this reflects a true decrease in incidence or the change to HbA1c-based diagnostic criteria is not clear.
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