Undiagnosed Diabetes and Pre-Diabetes in Health Disparities
Undiagnosed Diabetes and Pre-Diabetes in Health Disparities
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DOI：
10.1371/journal.pone.0133135
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发表时间：
2015-07-17
期刊：
影响因子：
3.7
通讯作者：
McCormick, Joseph B.
中科院分区：
文献类型：
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作者：
Fisher-Hoch, Susan P.;Vatcheva, Kristina P.;McCormick, Joseph B.
全球有一半的糖尿病未被诊断。我们试图确定居住在美国的墨西哥裔美国人中未确诊的2型糖尿病和糖尿病前期的程度和特征。这一一生中有50%糖尿病风险的弱势群体是当前流行病的一个缩影。我们访问了2004年至2014年期间招募到我们的卡梅隆县西班牙裔队列（CCHC）的2，838名成年人的基线数据;这是一个两阶段随机选择的“Framingham样”墨西哥裔美国人队列，位于美墨边境，具有严重的健康差异。我们研究了已诊断和未诊断的糖尿病和糖尿病前期的患病率、危险因素和代谢健康。三分之二的墨西哥裔美国人患有糖尿病或糖尿病前期。糖尿病患病率为28.0%，近一半未确诊，糖尿病前期为31.6%。糖尿病患者的平均BMI为33.5 kg/m2，而非糖尿病患者的平均BMI为29.0 kg/m2。重要的风险因素是低收入和教育水平。大多数糖尿病患者的腰臀比增加。缺乏保险和获得保健服务的机会是糖尿病得不到诊断的决定性因素。未确诊糖尿病和糖尿病前期的参与者有类似的代谢健康不良指标，类似但通常没有确诊糖尿病的参与者严重。在德克萨斯州南部，超过50%的墨西哥裔美国少数民族患有糖尿病或糖尿病前期，并且代谢不健康。只有三分之一的糖尿病病例被诊断出来。必须作出持续努力，以查明、诊断和治疗服务不足社区的个人。
Globally half of all diabetes mellitus is undiagnosed. We sought to determine the extent and characteristics of undiagnosed type 2 diabetes mellitus and pre-diabetes in Mexican Americans residing in the United States. This disadvantaged population with 50% lifetime risk of diabetes is a microcosm of the current pandemic. We accessed baseline data between 2004 and 2014 from 2,838 adults recruited to our Cameron County Hispanic Cohort (CCHC); a two-stage randomly selected 'Framingham-like' cohort of Mexican Americans on the US Mexico border with severe health disparities. We examined prevalence, risk factors and metabolic health in diagnosed and undiagnosed diabetes and pre-diabetes. Two thirds of this Mexican American population has diabetes or pre-diabetes. Diabetes prevalence was 28.0%, nearly half undiagnosed, and pre-diabetes 31.6%. Mean BMI among those with diabetes was 33.5 kg/m(2) compared with 29.0 kg/m(2) for those without diabetes. Significant risk factors were low income and educational levels. Most with diabetes had increased waist/hip ratio. Lack of insurance and access to health services played a decisive role in failure to have diabetes diagnosed. Participants with undiagnosed diabetes and pre-diabetes had similar measures of poor metabolic health similar but generally not as severe as those with diagnosed diabetes. More than 50% of a minority Mexican American population in South Texas has diabetes or pre-diabetes and is metabolically unhealthy. Only a third of diabetes cases were diagnosed. Sustained efforts are imperative to identify, diagnose and treat individuals in underserved communities.