Population Council Research that makes a difference

Abstract

Prevalence and control of diabetes and impaired fasting glucose in New York City 
Thorpe,Lorna E.; Upadhyay,Ushma D.; Chamany,Shadi; Garg,Renu; Mandel-Ricci,Jenna; Kellerman,Scott E.; Berger,Diana K.; Frieden,Thomas R.; Gynn,Charon
Diabetes Care 32(1): 57-62
Publication date: 2009


Objective
To determine the prevalence of diabetes andimpaired fasting glucose (IFG) and to assess clinical managementindicators among adults with diabetes in a representative sampleof New York City adults.

Research Design and Methods
In 2004, New York City implementedthe first community-level Health and Nutrition Examination Survey(NYC HANES), modeled after the National Health and NutritionExamination Survey (NHANES). We used an interview to determinepreviously diagnosed diabetes and measured fasting plasma glucoseto determine undiagnosed diabetes and IFG in a probability sampleof 1,336 New York City adults. We assessed glycemic controland other clinical indicators using standardized NHANES protocols.

Results
The prevalence of diabetes among New York Cityadults was 12.5% (95% CI 10.3-15.1): 8.7% diagnosed and3.8% undiagnosed. Nearly one-fourth (23.5%) of adults had IFG.Asians had the highest prevalence of impaired glucose metabolism(diabetes 16.1%, IFG 32.4%) but were significantly less likelyto be obese. Among adults with diagnosed diabetes, less thanone-half (45%) had A1C levels <7%; one-half (50%) had elevatedblood pressure measures at interview, 43% of whom were not onantihypertensive medications; nearly two-thirds (66%) had elevatedLDL levels, and only 10% had their glucose, blood pressure,and cholesterol all at or below recommended levels. Most adults(84%) with diagnosed diabetes were on medication, but only 12%were receiving insulin.

Conclusions
In New York City, diabetes and IFG are widespread.Policies and structural interventions to promote physical activityand healthy eating should be prioritized. Improved disease managementsystems are needed for people with diabetes.