Burden of prediabetes, undiagnosed, and poorly or potentially sub-controlled diabetes: Lolland-Falster health study

Abstract

Background This study aimed to investigate prevalence and risk factors for prediabetes, undiagnosed diabetes mellitus, poorly and potentially sub-controlled diabetes in a rural-provincial general adult population in Denmark. Methods Using cross-sectional data from the Lolland-Falster Health Study, we examined a total of 10,895 individuals aged 20 years and above. Results Prevalence of prediabetes was 5.8% (men: 6.1%; women: 5.5%); of undiagnosed diabetes 0.8% (men: 1.0%; women: 0.5%); of poorly controlled diabetes 1.2% (men: 1.5%; women: 0.8%); and of potentially sub-controlled diabetes 2% (men: 3.0%; women: 1.3%). In total, 9.8% of all participants had a diabetes-related condition in need of intervention; men at a higher risk than women; RR 1.41 (95% CI 1.26–1.58); person aged + 60 years more than younger; RR 2.66 (95% CI 2.34–3.01); obese more than normal weight person, RR 4.51 (95% CI 3.79–5.38); smokers more than non-smokers, RR 1.38 (95% CI 1.19–1.62); persons with self-reported poor health perception more than those with good, RR 2.59 (95% CI 2.13–3.15); low leisure time physical activity more than those with high, RR 2.64 (95% CI 2.17–3.22); and persons with self-reported hypertension more than those without, RR 3.28 (95% CI 2.93–3.68). Conclusions In the Lolland-Falster Health Study, nearly 10% of participants had prediabetes, undiagnosed diabetes, poorly controlled, or potentially sub-controlled diabetes. The risk of these conditions was more than doubled in persons with self-reported poor health perception, self-reported hypertension, low leisure time physical activity, or measured obesity, and a large proportion of people with diabetes-related conditions in need of intervention can therefore be identified relatively easily.

Undiagnosed diabetes: Prevalence and cardiovascular risk profile in a population‐based study of 52,856 individuals. The HUNT Study, Norway

“…The proportion of diabetes cases that were undiagnosed of 11% is low compared with previous reports of 22%–25%, 1–6 and far lower than IDF estimates from 2019 of 41% undiagnosed diabetes in Europe 7 . Nonetheless, several studies report declining proportions of undiagnosed diabetes, 2,4,24,25 and two population‐based studies from 2020 from Denmark and Greece found only 12% and 9% of patients with diabetes being undiagnosed, respectively 22,26 . In addition, a recent study from the UK Biobank found a similarly low prevalence of undiagnosed diabetes of 0.8% 23 …”

“…7 Nonetheless, several studies report declining proportions of undiagnosed diabetes, 2,4,24,25 and two population-based studies from 2020 from Denmark and Greece found only 12% and 9% of patients with diabetes being undiagnosed, respectively. 22 Prediabetes: HbA1c 39-47 mmol/mol (5.7%-6.4%) and no self report of diabetes.…”

“…This leads to some overestimation of undiagnosed diabetes, 31 compared with clinical practice where repeated elevated measurements of HbA1c are required for diabetes diagnosis in asymptomatic persons 21 . Furthermore, although most of the recent studies on undiagnosed diabetes in Europe have used HbA1c as their screening test, including all the individual studies that we have compared our results to, 1–5,22,23,26 it is important to take into consideration the poor concordance between HbA1c, fasting plasma glucose and oral glucose tolerance tests (OGTTs) in detecting diabetes, when comparing our results with previous studies. When using a single measurement, HbA1c has been shown to detect fewer patients than an OGTT.…”

Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study

“…In our study population, the known prevalence of type 2 diabetes is also relatively high (2.9-6.4% [31] ), partly due to a large population of citizens of middle East origin at increased risk of type 2 diabetes [32] and a population of low socio-economic status. No current data are available on prediabetes in the studied area, but a recent study from a socio-economic comparable part of Denmark reported a prevalence of prediabetes of 5.8% and unknown diabetes of 0.8% [33] . As the prevalence of dysglycemia is high in our study compared to the background population, we find it of importance to screen patients with COVID-19 with HbA 1c at admission.…”

Preferential impairment of parasympathetic autonomic function in type 2 diabetes

“…The control subjects were normotensive with a BMI of only 24.2 and thus less likely to have metabolic syndrome or T2D. Additionally, based on improved diagnostic activity over the last decade in Denmark the prevalence of non-diagnosed diabetes is low with estimated 0.6-0.8 % undiagnosed T2D patients in the aged 20-85 years (Jørgensen et al, 2020;Bruun-Rasmussen et al, 2020). Therefore, although not tested, cases of undiagnosed T2D in our control cohort is unlikely.…”