NCHS Data Brief ■ No. 319 ■ September 2018

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Prevalence of Total, Diagnosed, and Undiagnosed Diabetes 

Among Adults: United States, 2013–2016 

 Nicholas D. Mendola, M.P.H., Te-Ching Chen, Ph.D., Qiuping Gu, M.D., Ph.D., 

Mark S. Eberhardt, Ph.D., and Sharon Saydah, Ph.D.

Key findings

Data from the National 

Health and Nutrition 

Examination Survey 

(NHANES)

● In 2013–2016, the 

prevalence of total diabetes 

was 14.0%; the prevalence 

of diagnosed diabetes was 

9.7%; and the prevalence of 

undiagnosed diabetes was 4.3% 

among U.S. adults. 

● The prevalence of total 

diabetes was higher among men 

(15.9%) than among women 

(12.2%). 

● The prevalence of total, 

diagnosed, and undiagnosed 

diabetes increased with age. 

● The prevalence of total, 

diagnosed, and undiagnosed 

diabetes was higher in Hispanic 

adults than in non-Hispanic 

white adults. The prevalence 

of total and diagnosed diabetes 

was higher among non-Hispanic 

black adults compared with 

non-Hispanic white adults.

● The prevalence of total, 

diagnosed, and undiagnosed 

diabetes increased with 

increasing weight status 

category.

Diabetes is a major cause of morbidity and mortality in the United States 

(1–3). Diabetes can be present but undiagnosed, meaning that a person can 

have diabetes but not report having ever been told by a doctor or health 

professional that they have the condition. Type 2 diabetes can progress over 

an extended time period with gradual, often unnoticed, changes occurring 

before diagnosis. If left unmanaged, diabetes may contribute to serious health 

outcomes including neuropathy, nephropathy, retinopathy, coronary artery 

disease, stroke, and peripheral vascular disease (4). This report presents the 

prevalence of total, diagnosed, and undiagnosed diabetes in U.S. adults in 

2013–2016.

Keywords: fasting plasma glucose • hemoglobin A1c • NHANES 

During 2013–2016, the prevalence of total diabetes was 

higher among men than among women.

Figure 1. Age-adjusted prevalence of total, diagnosed, and undiagnosed diabetes among adults 

aged 20 and over, by sex: United States, 2013–2016

 

https://www.cdc.gov/nchs/data/databriefs/db319_table.pdf#1 
NCHS Data Brief ■ No. 319 ■ September 2018

■  2  ■

● The prevalence of total diabetes was 14.0% among adults. The prevalence of diagnosed and 

undiagnosed diabetes was 9.7% and 4.3%, respectively (Figure 1).

● Men had a higher prevalence of total diabetes (15.9%) compared with women (12.2%), but 

differences in diagnosed and undiagnosed diabetes by sex were not significant.

The prevalence of total, diagnosed, and undiagnosed diabetes increased 

with age.

● The prevalence of total diabetes was 3.5% among adults aged 20–39, 16.3% among adults 

aged 40–59, and 28.2% among adults aged 60 and over (Figure 2). 

● The prevalence of diagnosed diabetes was 1.8% among adults aged 20–39, 11.1% among 

adults aged 40–59, and 21.0% among adults aged 60 and over. 

● The prevalence of undiagnosed diabetes was 1.7% among adults aged 20–39, 5.2% among 

adults aged 40–59, and 7.2% among adults aged 60 and over.

Figure 2. Prevalence of total, diagnosed, and undiagnosed diabetes among adults aged 20 and over, by age group: 

United States, 2013–2016

 

https://www.cdc.gov/nchs/data/databriefs/db319_table.pdf#2 
NCHS Data Brief ■ No. 319 ■ September 2018

■  3  ■

The prevalence of total, diagnosed, and undiagnosed diabetes varied by 

race and Hispanic origin. 

● Total diabetes was higher among non-Hispanic black (17.9%) and Hispanic (19.8%) adults 

compared with non-Hispanic white (12.4%) adults; total diabetes was also higher for 

Hispanic compared with non-Hispanic Asian (15.3%) adults (Figure 3).

● The prevalence of diagnosed diabetes was higher in Hispanic (13.6%) and non-Hispanic 

black (13.9%) adults compared with non-Hispanic Asian (10.2%) and non-Hispanic white 

(8.5%) adults.

● The prevalence of undiagnosed diabetes was higher in Hispanic (6.2%) adults compared 

with non-Hispanic white (3.9%) and non-Hispanic black (4.0%) adults.

Figure 3. Age-adjusted prevalence of total, diagnosed, and undiagnosed diabetes among adults aged 20 and over, by 

race and Hispanic origin: United States, 2013–2016

 

 
NCHS Data Brief ■ No. 319 ■ September 2018

■  4  ■

The prevalence of total, diagnosed, and undiagnosed diabetes increased 

with increasing weight status category.

● The prevalence of total diabetes increased with increasing weight status category, from 6.2% 

among underweight or normal weight adults to 11.8% among overweight adults to 20.7% 

among adults with obesity (Figure 4).

● The prevalence of diagnosed diabetes increased with increasing weight status category, 

from 4.3% among underweight or normal weight adults to 8.6% among overweight adults to 

14.0% among adults with obesity. 

● The prevalence of undiagnosed diabetes increased with increasing weight status category, 

from 1.9% among underweight or normal weight adults to 3.2% among overweight adults to 

6.8% among adults with obesity.

Figure 4. Age-adjusted prevalence of total, diagnosed, and undiagnosed diabetes among adults aged 20 and over, by 

weight status category: United States, 2013–2016

 

https://www.cdc.gov/nchs/data/databriefs/db319_table.pdf#4 
NCHS Data Brief ■ No. 319 ■ September 2018

■  5  ■

Summary

In 2013–2016, the prevalence of total diabetes was 14.0% among U.S. adults. The prevalence 

of diagnosed diabetes was 9.7%, and the prevalence of undiagnosed diabetes was 4.3%. These 

results show that among all adults with diabetes, 30.7% had undiagnosed diabetes.

Men had a higher prevalence of total diabetes than women. The prevalence of total, diagnosed, 

and undiagnosed diabetes increased with age and weight status. Differences were seen in the 

prevalence of diagnosed, undiagnosed, and total diabetes among the race and Hispanic-origin 

groups. The prevalence of total, diagnosed, and undiagnosed diabetes was higher among Hispanic 

adults than among non-Hispanic white adults, and the prevalence of total and diagnosed diabetes 

was higher among non-Hispanic black adults than among non-Hispanic white adults. No 

significant differences were seen in the prevalence of total, diagnosed, or undiagnosed diabetes 

between non-Hispanic Asian and non-Hispanic white adults.

Continued monitoring of total, diagnosed, and undiagnosed diabetes will provide information 

about the burden of diabetes among adults in the United States.

Definitions

Diagnosed diabetes: Participants were classified as having diagnosed diabetes if they answered 

“yes” to the question: “Other than during pregnancy, have you ever been told by a doctor or 

health professional that you have diabetes or sugar diabetes?” 

Undiagnosed diabetes: Participants were classified as having undiagnosed diabetes if they did 

not report a diagnosis of diabetes by a health care provider, and their fasting (8–24 hours) plasma 

glucose was greater than or equal to 126 mg/dL or their hemoglobin A1c was greater than or 

equal to 6.5%. 

Total diabetes: Combined overall prevalence of diagnosed and undiagnosed diabetes.

Weight status: Body mass index (BMI) was calculated as measured weight in kilograms divided 

by measured height in meters squared and rounded to one decimal place. Overweight was defined 

as a BMI greater than or equal to 25 and less than 30. Obesity was defined as a BMI greater than 

or equal to 30. Normal or underweight was defined as a BMI less than 25.
NCHS Data Brief ■ No. 319 ■ September 2018

■  6  ■

Data source and methods

NHANES is a cross-sectional, complex, multistage probability sample of the U.S. 

noninstitutionalized population. The survey consists of interviews conducted in participants’ 

homes, standardized physical examinations in mobile examination centers, and laboratory tests on 

blood and other specimens. During 2013–2016, Hispanic, non-Hispanic black, and non-Hispanic 

Asian persons, among other groups, were oversampled to obtain reliable estimates on these 

subgroups. Race- and Hispanic-origin-specific estimates reflect individuals reporting only one 

race; those reporting more than one race are included in the total but are not reported separately.

Criteria from the American Diabetes Association were used to define diabetes (5). Participants 

were randomly assigned to a morning, afternoon, or evening exam. Fasting plasma glucose data 

from the morning exam (after an 8- to 24-hour fast) were used to define total and undiagnosed 

diabetes. BMI was calculated as weight in kilograms divided by height in meters squared and 

rounded to one decimal place. Pregnant women were excluded. Fasting sample weights were used 

to account for differential probabilities of selection, nonresponse, and noncoverage. 

The standard errors of percentages were estimated using Taylor series linearization. Estimates 

were age adjusted to the projected 2000 U.S. census population using age groups 20–39, 40–59, 

and 60 and over (6). Pairwise differences between groups were evaluated using t statistics. Stated 

differences were statistically significant at p less than 0.05. Orthogonal contrasts were used to test 

for linear trends across categories of age and weight status. Statistical analyses were conducted 

using SAS release 9.4 (SAS Institute Inc., Cary, N.C.) and SAS-callable SUDAAN release 11.0 

(RTI International, Research Triangle Park, N.C.).

About the authors

Nicholas D. Mendola was a student volunteer with the National Center for Health Statistics 

(NCHS), Division of Health and Nutrition Examination Surveys, and a graduate student at the 

George Washington University Milken Institute School of Public Health during the analysis 

and writing of this report. Te-Ching Chen, Qiuping Gu, and Mark S. Eberhardt are with NCHS’ 

Division of Health and Nutrition Examination Surveys. Sharon Saydah is with the National 

Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation.
NCHS Data Brief ■ No. 319 ■ September 2018

■  7  ■

References

1. Centers for Disease Control and Prevention. National diabetes statistics report, 2017: 

Estimates of diabetes and its burden in the United States. Atlanta, GA: U.S. Department of Health 

and Human Services. 2017. Available from: https://www.cdc.gov/diabetes/pdfs/data/statistics/

national-diabetes-statistics-report.pdf. 

2. Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and trends in diabetes among 

adults in the United States, 1988–2012. JAMA 314(10):1021–9. 2015. 

3. Heron M. Deaths: Leading causes for 2016. National Vital Statistics Reports; vol 67 no 6. 

Hyattsville, MD: National Center for Health Statistics. 2018. 

4. Beagley J, Guariguata L, Weil C, Motala AA. Global estimates of undiagnosed diabetes in 

adults. Diabetes Res Clin Pract 103(2):150–60. 2014.

5. American Diabetes Association. Classification and diagnosis of diabetes: Standards of 

medical care in diabetes—2018. Diabetes Care 41(Suppl 1):S13–S27. 2018.

6. Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected U.S. population. Healthy 

People Statistical Notes, no 20. Hyattsville, MD: National Center for Health Statistics. 2001.
NCHS Data Brief ■ No. 319 ■ September 2018

Suggested citation

Mendola ND, Chen T-C, Gu Q, Eberhardt 

MS, Saydah S. Prevalence of total, 

diagnosed, and undiagnosed diabetes 

among adults: United States, 2013–2016. 

NCHS Data Brief, no 319. Hyattsville, MD: 

National Center for Health Statistics. 2018.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health and Nutrition 

Examination Surveys

Kathryn S. Porter, M.D., M.S., Director

Ryne Paulose-Ram, M.A., Ph.D., Associate 

Director for Science

For e-mail updates on NCHS publication 

releases, subscribe online at: 

https://www.cdc.gov/nchs/govdelivery.htm.

For questions or general information

about NCHS:

Tel: 1–800–CDC–INFO (1–800–232–4636)

TTY: 1–888–232–6348

Internet: https://www.cdc.gov/nchs

Online request form: https://www.cdc.gov/info

ISSN 1941–4927 Print ed.

ISSN 1941–4935 Online ed.

DHHS Publication No. 2018–1209

CS295378

U.S. DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention 

National Center for Health Statistics 

3311 Toledo Road, Room 4551, MS P08

Hyattsville, MD 20782–2064

OFFICIAL BUSINESS 

PENALTY FOR PRIVATE USE, $300

For more NCHS Data Briefs, visit:

https://www.cdc.gov/nchs/products/databriefs.htm.

FIRST CLASS MAIL 

POSTAGE & FEES PAID 

CDC/NCHS

PERMIT NO. G-284