The prevalence and determinants of undiagnosed and diagnosed type 2 diabetes in middle-aged Irish adults

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Date
2013
Authors
O'Connor, Jennifer M.
Millar, Sean R.
Buckley, Claire M.
Kearney, Patricia M.
Perry, Ivan J.
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Public Library of Science
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Abstract
Background: The prevalence of type 2 diabetes within the Republic of Ireland is poorly defined, although a recent report suggested 135,000 cases in adults aged 45+, with approximately one-third of these undiagnosed. This study aims to assess the prevalence of undiagnosed and diagnosed diabetes in middle-aged adults, and compare features related to either condition, in order to investigate why certain individuals remain undetected. Methods: This was a cross-sectional study involving a sample of 2,047 men and women, aged between 50-69 years, randomly selected from a large primary care centre. Univariate logistic regression was used to explore socio-economic, metabolic and other health related variable associations with undiagnosed or diagnosed diabetes. A final multivariate analysis was used to determine odds ratios and 95% confidence intervals for having undiagnosed compared to diagnosed diabetes, adjusted for gender, age and significant covariates determined from univariate models. Principle Findings: The total prevalence of diabetes was 8.5% (95% CI: 7.4%-8.8%); 72 subjects (3.5%) had undiagnosed diabetes (95% CI: 2.8%-4.4%) and 102 subjects (5.0%) had diagnosed diabetes (95% CI: 4.1%-6.0%). Obesity, dyslipidaemia, and family history of diabetes were positively associated with both undiagnosed and diagnosed type 2 diabetes. Compared with diagnosed subjects, study participants with undiagnosed diabetes were significantly more likely to have low levels of physical activity and were less likely to be on treatment for diabetes-related conditions or to have private medical insurance. Conclusions: The prevalence of diabetes within the Cork and Kerry Diabetes and Heart Disease Study is comparable to recent estimates from the Slan National Health and Lifestyle Survey, a study which was nationally representative of the general population. A considerable proportion of diabetes cases were undiagnosed (41%), emphasising the need for more effective detection strategies and equitable access to primary healthcare.
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Keywords
Fasting plasma glucose , US population , Self-reports , Health care , High risk , A1C , Hypertension , Agreement , Criteria , Individuals
Citation
O Connor JM, Millar SR, Buckley CM, Kearney PM, Perry IJ (2013) The Prevalence and Determinants of Undiagnosed and Diagnosed Type 2 Diabetes in Middle-Aged Irish Adults. PLoS ONE 8(11): e80504. doi:10.1371/journal.pone.0080504