Prevalence, Trends, and Subsequent Outcomes of Prediabetes in the United States, 1999-2018
Authors' conclusion
In the United States, approximately 1 in 3 individuals have prediabetes according to ADA criteria. The prevalence of prediabetes has shown a significant and more than twofold increase over the past 2 decades, posing an elevated risk of diabetes-related mortality, regardless of the criteria applied.
Study context
- Population
- US NHANES participants, 1999–2018; weighted mean age 41.1 years, 48.7% male
- Participants
- 59,369 participants
- Exposure
- Prediabetes vs normal glycemia
- Outcome
- Prevalence of prediabetes
- Follow-up
- 1999–2018
Methodological details10 cycles of NHANES, mortality follow-up with Cox proportional regression
- 10 cycles of NHANES
- Mortality follow-up with Cox proportional regression
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Diabetes-related mortalityPrediabetes (ADA)vs Normal glycemiaAdjusted | 9.11 (5.83–14.22) | |
| Diabetes-related mortalityPrediabetes (WHO)vs Normal glycemiaAdjusted | 5.35 (3.01–9.51) | |
| Diabetes-related mortalityPrediabetes (IEC)vs Normal glycemiaAdjusted | 9.64 (5.92–15.71) | |
| 0.050.21520Hazard ratio (log scale) |
Trend in covariate-adjusted prevalence of prediabetes (American Diabetes Association (ADA)) · 1999-2002 to 2015-2018
- Adjusted prevalence 1999-2002
- 15.6%
- Adjusted prevalence 2015-2018
- 37.3%
- Significant increase, at least twofold
- P < 0.001
Trend in prevalence of prediabetes (World Health Organization (WHO) and International Expert Committee (IEC))
- Similar significant increased trends
- P < 0.001
All-cause and CV mortality
- No significant associations between prediabetes and all-cause or CV mortality in adjusted models
Original publication
Prevalence, Trends, and Subsequent Outcomes of Prediabetes in the United States, 1999-2018. Endocr Pract. Published 19 September 2024. doi:10.
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