Diabetes Was Often Undiagnosed

Diabetes was undiagnosed in almost a third of patients who had the condition

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) What you don't know about your health might hurt you. New research found that many people had a chronic illness without knowing it.

A new study found that many patients who had diabetes had not been diagnosed and did not know they had the disease.

"The classic symptoms of diabetes: are excessive thirst, frequent urination, and constant hunger," said Jinju Weiss, DO, of Baylor Medical Center at McKinney and Baylor Family Medicine at Aubrey.

"You should seek medical help if you experience these symptoms," said Dr. Weiss, who was not involved in this study. "Your doctor can do a simple test to rule out diabetes."

Mohammed K. Ali, MBChB, of the Centers for Disease Control and Prevention in Atlanta, and colleagues studied data from the 2007 to 2012 National Health and Nutrition Examination Survey (NHANES). NHANES included 29,353 men and women aged 18 or older. The study participants completed a household interview and had a physical exam.

As a part of the NHANES, researchers drew some of the patients' blood for lab work. Dr. Ali and team looked at data on 8,827 patients who had their blood drawn in the morning after not eating for nine hours. They looked at two factors: glycated hemoglobin A1c (HbA1c) and fasting plasma glucose.

Based on these factors, the study authors found that 1,272 of these patients had diabetes, but 352 had never been diagnosed with the disease.

HbA1c measures a patient’s blood sugar over a period of time. A low HbA1c means blood sugar is well-controlled. A high HbA1c indicates the blood sugar has been too high over a period of time.

Fasting glucose measures the patient’s blood sugar at the time the blood was drawn. A high HbA1c combined with high fasting blood sugar can indicate that the patient has diabetes.

Dr. Ali and team used the "cascade of care" method — a chart that plots large amounts of data to help medical professionals see which people aren't receiving the care they need to manage a condition — to identify gaps in care for people with diabetes. This study marked the first time the cascade of care method was applied to diabetes.

These researchers said that addressing gaps in diabetes care could prevent complications in many patients.

"The cascade-of-care concept can be a powerful tool to visualize gaps and disparities across groups and improve engagement and health care quality," the researchers wrote. "It has worked for HIV, a chronic infectious disease requiring lifelong medication adherence and immune monitoring, and may have benefits for other chronic diseases.”

Dr. Ali and team looked for type 2 diabetes in the study participants. Type 2 diabetes is a disease in which the body does not produce enough insulin — a hormone that regulates blood sugar. Chronic high blood sugar can cause damage to cells. Untreated diabetes can result in heart disease, kidney failure and a host of other health problems.

Dr. Ali and colleagues also looked at whether the patients had seen a doctor. More than 95 percent of the patients who knew they had diabetes had a regular care provider, and 91.7 percent had made two or more visits to their doctors in the past year.

Among undiagnosed patients, however, only 84.5 percent had a care provider. Only 66.5 percent reported two or more doctor visits in the past year.

Patients with diabetes who had not been diagnosed were less likely to receive care and less likely to have their blood sugar, blood pressure and cholesterol under control.

This study was published online Nov. 17 in Annals of Internal Medicine.

The authors disclosed no funding sources or conflicts of interest.

Review Date: 
November 18, 2014
Last Updated:
November 21, 2014