What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Diabetes (diagnosed and undiagnosed). Intervention: Obesity (BMI ≥ 30 kg/m2) vs. Normal weight (BMI < 25 kg/m2). Primary outcome: Undiagnosed diabetes (FPG ≥ 126 mg/dL) (OR 4.29, 95% CI 2.25-8.17).

September 25, 2009Population Health MetricsOpen Access

Diabetes prevalence and diagnosis in US states: analysis of health surveys

Q: What are the key findings of this study?

Diabetes prevalence was highest in Southern and Appalachian states, and among those without a prior diagnosis, obesity was strongly associated with having undiagnosed diabetes (OR 4.29).

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Key result

Diabetes prevalence was highest in Southern and Appalachian states, and among those without a prior diagnosis, obesity was strongly associated with having undiagnosed diabetes (OR 4.29).

Population

Civilian non-institutionalized US adults aged 30 and older from the National Health and Nutrition…

Design

Cross-sectional

Authors

GDGoodarz DanaeiPreventive Cardiology AFAri B. FriedmanUniversity of Pennsylvania Health System SOShefali OzaHarvard University Press

Discussion

Member takes

Implication

May inform targeted screening in high-burden states; cross-sectional data leaves open causal pathways for prospective confirmation.

Study Design

Type

Cross-Sectional

Structured PICO

Population

Adults aged 30 and older from the US NHANES (2003-2006) and BRFSS (2003-2007) surveys, analyzed to estimate state-level prevalence of diagnosed and undiagnosed diabetes.

Outcome

State-level prevalence of diagnosed and undiagnosed diabetes by age group and sex

Main Result

Odds Ratio: 4.29 (95% CI 2.25–8.17)

Diabetes prevalence and the proportion of undiagnosed cases vary significantly across US states, with the highest burden in Southern and Appalachian states, highlighting the need for targeted state-level screening and management programs.

Limitations

Inability to include family history of diabetes, physical activity, and specific dietary risk factors in the model due to BRFSS limitations.
Use of fasting plasma glucose (FPG) only to define diabetes, rather than including glucose tolerance tests.
BRFSS response rates varied across states, which may affect state comparisons if non-response is associated with diabetes prevalence.
High rate of missing data (50.2%) for smoking and insurance status in NHANES required the use of a missing indicator.
Self-reported diabetes prevalence may be biased because respondents may not be aware of their risk status
Sampling standard error underestimates the true standard error by not incorporating parameter and stochastic uncertainty of the prediction model

Cite This Study

Danaei et al. (2009) conducted a cross-sectional in Diabetes (diagnosed and undiagnosed). Obesity (BMI ≥ 30 kg/m2) vs. Normal weight (BMI < 25 kg/m2) was evaluated on Undiagnosed diabetes (FPG ≥ 126 mg/dL) (OR 4.29, 95% CI 2.25-8.17). Diabetes prevalence was highest in Southern and Appalachian states, and among those without a prior diagnosis, obesity was strongly associated with having undiagnosed diabetes (OR 4.29).

synapsesocial.com/papers/6a2058dfece94d65a85ad4e0 https://doi.org/10.1186/1478-7954-7-16

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Diabetes prevalence and diagnosis in US states: analysis of health surveys

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Diabetes prevalence and diagnosis in US states: analysis of health surveys

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider