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

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

Research output: Contribution to journalArticle

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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 25 490 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 = 16 880), 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.

Original languageEnglish (US)
Pages (from-to)760-769
Number of pages10
JournalAmerican Heart Journal
Volume170
Issue number4
DOIs
StatePublished - Oct 1 2015
Externally publishedYes

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Young Adult
Cardiovascular Diseases
LDL Lipoproteins
Hypertension
Glucose
Fasting
Obesity
Cross-Sectional Studies
Smoking
Demography
Guidelines
Delivery of Health Care
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Undiagnosed diabetes is prevalent in younger adults and associated with a higher risk cardiometabolic profile compared to diagnosed diabetes. / Lee, Yong Ho; Armstrong, Ehrin J.; Kim, Gyuri; Oh, Jaewon; Kang, Seok Min; Lee, Byung Wan; Ahn, Chul Woo; Cha, Bong Soo; Lee, Hyun Chul; Mantzoros, Christos S.; Kang, Eun Seok.

In: American Heart Journal, Vol. 170, No. 4, 01.10.2015, p. 760-769.

Research output: Contribution to journalArticle

Lee, YH, Armstrong, EJ, Kim, G, Oh, J, Kang, SM, Lee, BW, Ahn, CW, Cha, BS, Lee, HC, Mantzoros, CS & Kang, ES 2015, 'Undiagnosed diabetes is prevalent in younger adults and associated with a higher risk cardiometabolic profile compared to diagnosed diabetes', American Heart Journal, vol. 170, no. 4, pp. 760-769. https://doi.org/10.1016/j.ahj.2015.07.024
Lee, Yong Ho ; Armstrong, Ehrin J. ; Kim, Gyuri ; Oh, Jaewon ; Kang, Seok Min ; Lee, Byung Wan ; Ahn, Chul Woo ; Cha, Bong Soo ; Lee, Hyun Chul ; Mantzoros, Christos S. ; Kang, Eun Seok. / Undiagnosed diabetes is prevalent in younger adults and associated with a higher risk cardiometabolic profile compared to diagnosed diabetes. In: American Heart Journal. 2015 ; Vol. 170, No. 4. pp. 760-769.
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T1 - Undiagnosed diabetes is prevalent in younger adults and associated with a higher risk cardiometabolic profile compared to diagnosed diabetes

AU - Lee, Yong Ho

AU - Armstrong, Ehrin J.

AU - Kim, Gyuri

AU - Oh, Jaewon

AU - Kang, Seok Min

AU - Lee, Byung Wan

AU - Ahn, Chul Woo

AU - Cha, Bong Soo

AU - Lee, Hyun Chul

AU - Mantzoros, Christos S.

AU - Kang, Eun Seok

PY - 2015/10/1

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N2 - 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 25 490 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 = 16 880), 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.

AB - 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 25 490 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 = 16 880), 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.

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