Rethinking Rates of Undiagnosed Diabetes: The Value of a Confirmatory Test
Authors: Anne L. Peters
Journal: Annals of Internal Medicine (2017)

Editorials5 December 2017Rethinking Rates of Undiagnosed Diabetes: The Value of a Confirmatory TestAnne L. Peters, MDAnne L. Peters, MDKeck School of Medicine of the University of Southern California Los Angeles, California (A.L.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-2576 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail It is believed that many diabetes cases—approximately 25%—in the United States are undiagnosed (1, 2). This conclusion is based on epidemiologic surveys of respondents who had 1 test of glycemia to measure their level of fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), or 2-hour glucose as part of a glucose tolerance test. However, for persons with no diabetes symptoms, the American Diabetes Association (ADA) currently recommends repeating a positive test to confirm the diagnosis. Confirmation may be done by using the same test (for example, a repeated measurement of FPG level if the previous one was elevated) or a second ...References1. Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and trends in diabetes among adults in the United States, 1988-2012. JAMA. 2015;314:1021-9. [PMID: 26348752] doi:10.1001/jama.2015.10029 CrossrefMedlineGoogle Scholar2. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017. Accessed at www.cdc.gov/diabetes/data/statistics/statistics-report.html on 25 September 2017. Google Scholar3. American Diabetes Association. 2. Classification and diagnosis of diabetes. Diabetes Care. 2017;40:S11-S24. [PMID: 27979889] CrossrefMedlineGoogle Scholar4. Selvin E, Crainiceanu CM, Brancati FL, Coresh J. Short-term variability in measures of glycemia and implications for the classification of diabetes. Arch Intern Med. 2007;167:1545-51. [PMID: 17646610] CrossrefMedlineGoogle Scholar5. Selvin E, Wang D, Lee AK, Bergenstal RM, Coresh J. Identifying trends in undiagnosed diabetes in U.S. adults by using a confirmatory definition. A cross-sectional study. Ann Intern Med. 2017;167:769-76. doi:10.7326/M17-1272 LinkGoogle Scholar6. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997;20:1183-97. [PMID: 9203460] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Keck School of Medicine of the University of Southern California Los Angeles, California (A.L.P.)Disclosures: Author has disclosed no conflicts of interest. Form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2576.Corresponding Author: Anne L. Peters, MD, 9033 Wilshire Boulevard, Beverly Hills, CA 90211; e-mail, [email protected]usc.edu.This article was published at Annals.org on 24 October 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSelf-administered Versus Directly Observed Once-Weekly Isoniazid and Rifapentine Treatment of Latent Tuberculosis Infection Robert Belknap , David Holland , Pei-Jean Feng , Joan-Pau Millet , Joan A. Caylà , Neil A. Martinson , Alicia Wright , Michael P. Chen , Ruth N. Moro , Nigel A. Scott , Bert Arevalo , José M. Miró , Margarita E. Villarino , Marc Weiner , Andrey S. Borisov , and Identifying Trends in Undiagnosed Diabetes in U.S. Adults by Using a Confirmatory Definition Elizabeth Selvin , Dan Wang , Alexandra K. Lee , Richard M. Bergenstal , and Josef Coresh Metrics Cited byThe prevalence of undiagnosed type 2 diabetes and prediabetes in Eastern Mediterranean region (EMRO): A systematic review and meta-analysis 5 December 2017Volume 167, Issue 11Page: 822-823KeywordsEpidemiologyGlucoseHbA1cHealth careHealth surveysMedical risk factorsObesityOral glucose tolerance testPrevention, policy, and public healthRacial and ethnic issues ePublished: 24 October 2017 Issue Published: 5 December 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...