Diabetes prevalence, awareness, and control in the United States, 2017-2023

Abstract

Introduction

We compared diabetes prevalence, awareness, and control pre versus post the Covid-19 pandemic.

Methods

This was a cross-sectional analysis of the U.S. National Health and Nutrition Examination Surveys pre (2017–2020) and post (2021–2023) the pandemic. We included all non-pregnant adults (aged ≥ 20 years) who had undergone biomedical testing. Diagnosed and undiagnosed diabetes was defined as self-reported diabetes and no self-reported diabetes with HbA1c >6.5 % or fasting plasma glucose ≥126 mg/dL, respectively. Among diagnosed diabetes, we estimated proportions achieving glycemic (HbA1c < 7.0 %), blood pressure (< 130/80 mmHg), and cholesterol control (non-high-density lipoprotein < 130mg/dl), and use of blood pressure and lipid lowering medications.

Results

The prevalence of total diabetes, diagnosed diabetes, undiagnosed diabetes, and proportion of diabetes that was undiagnosed remained stable between pre and post pandemic periods: from 16.2 % [95 %CI: 14.3–18.1] to 15.8 % [13.7–17.9], from 11.7 % [10.1–13.2] to 11.3 % [9.4–13.2], from 4.6 % [3.8–5.3]) to 4.5 % [3.4–5.6]), and from 28.1 % [24.3–31.8] to 28.4 % [21.9–35.0], respectively. Among those with diagnosed diabetes, glycemia, blood pressure, lipid control, and use of blood pressure or lipid medication did not significantly change.

Conclusions

Between 2017–2020 and 2021–2023, there were no significant changes in diabetes prevalence, awareness, and control in the U.S. population.