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Indicator Details: Age-Adjusted Percentage Reporting Having Diabetes
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In 2013-2014, after adjustments for age, self-reported diabetes was highest in Mexican-Americans (15%) and non-Hispanic blacks (14% vs. 9% in non-Hispanic whites) and in those with obesity (15% vs. 6%).

With age adjustment, diabetes prevalence amongst participants > 60 years of age, defined by self-report, diabetes medication, and A1C >6.5%, has increased significantly from 20% in 1999-2000 to 25% in 2013-2014 (ptrend<.001).  
Chart Explanation: The age-adjusted prevalence of self-reported diabetes among adults in 2013-2014 was only slightly higher in males than females (10.3% vs 9.6%). Mexican-Americans (15.2%) had a higher prevalence age-adjusted prevalence than non-Hispanic blacks (13.9%) or whites (8.6%). Age-adjusted prevalence amongst those with obesity 15.5%, compared to 6.2% in those without obesity. 

The age-adjusted prevalence of diabetes as defined by self-report, diebetes medication, or measured A1C > 6.5% in the older U.S. adult population (age >60 years) has significantly increased from 1999-2000 to 2013-2014 (p-trend <.001).
The NHANES (National Health and Nutrition Examination Survey) is a nationally representative, cross-sectional survey that is currently conducted every 2 years by the Centers for Disease Controla and Prevention's National Center for Health Statistics to examine disease prevalence and trends over time in noninstitutionalized U.S. civilian residents.

Diabetes-associated nephropathy is one of the two main causes of CKD. Diabetic nephropathy accounts for 30-40% of CKD and 44% of incident ESRD in the United States (United States Renal Data System, 2011). Additionally, diabetes-related CKD is associated with high rates of morbidity and mortality (Foley et al., 2005; Go, Chertow, Fan, McCulloch, & Hsu, 2004). Thus, assessing the burden of this risk factor is essential to CKD surveillance. The NHANES surveys are currently conducted every 2 years by the CDC's National Center for Health Statistics to examine disease prevalence and trends over time in different cross-sectional representative samples of noninstitutionalized U.S. civilian residents. The survey consists of a standardized in-home interview and a physical examination and blood and urine collection at a mobile examination center (MEC). Here we examined data from the 1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, and 2013-2014 NHANES. Self-reported diabetes was defined by answer of “yes” to the question “have you ever been told by a doctor or other health professional that you have diabetes or sugar diabetes?” Glycohemoglobin, which was approved as a diagnostic test for diabetes in 2010 (American Diabetes Association, 2010), was measured in all participants; fasting glucose and oral glucose tolerance tests (2005-2016 only) were conducted in subsets of the NHANES participants. Medications were recorded from prescription bottles during the interview; metformin HCL, insulin, glimepiride, glipizide, glyburide, pioglitazone, rosiglitazone, meglitinides, DPP-4 inhibitors, GLP-1 receptors, SGLT2 inhibitors and any combination thereof were considered diabetes medications.
Description of MeasurePrevalence of diabetes mellitus and glycemic control in the general population
Data SourceNCHS
Type of Data SourcePublic
Health Care System DataNo
Regional or National?National
Demographic GroupNon-institutionalized U.S. residents aged 12+ years (20+ for adults)
NumeratorNon-pregnant participants with completed surveys or fasting glucose levels who report having diabetes (or with elevated fasting glucose)
DenominatorNon-pregnant participants with completed surveys (or fasting glucose levels)
Primary Data Source Indicatordiq010: “Other than during pregnancy, have you ever been told by a doctor or health professional that you have diabetes or sugar diabetes?” yes/no
Primary Indicator Method of MeasurementQuestionnaire (interviewer-administered); ages 1+
Secondary (1) Variablelbxglu: Fasting plasma glucose (subsample)
Secondary (1) Indicator Method of MeasurementExamination/Laboratory
Secondary (2) Variablerhd143, rhd141/rhd140, urxpreg: current pregnancy
Secondary (2) Indicator Method of MeasurementQuestionnaire (interviewer-administered) or exam (urine pregnancy status)
Secondary (3) Variablenhcode/rxddrgid: generic drug codes
Secondary (3) Indicator Method of MeasurementQuestionnaire (interviewer-administered), with recording of medications from Rx bottles
Frequency of Measurement (Primary)Once (cross-sectional)
U.S. Region Covered by Primary VariableAll
Period Currently Available1999–2016
Pending Data2015-2016
Additional Data Items of InterestStage of CKD, stratification variables of interest (age, gender, race/ethnicity, BMI, hypertension by self-report)
Limitations of IndicatorFasting plasma glucose only on a subsample of morning participants who were fasting; OGTT available for 2005-2014 only
Analytic ConsiderationsAppropriate NHANES survey weights, including fasting and OGTT weights, must be used for all analyses; glucose values must be converted for 2005-2006 and 2007-2008; OGTT only measured on those without diabetes
Age AdjustmentAdjusted for the distribution of age within the sample.
References and Sources:
  • Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296-305.
  • Foley RN, Murray AM, Li S, et al. Chronic kidney disease and the risk for cardiovascular disease, renal replacement, and death in the United States Medicare population, 1998 to 1999. J Am Soc Nephrol. 2005;16(2):489-95.
  • National Institute of Diabetes and Digestive and Kidney Diseases. USRDS 2011 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, Bethesda, MD: National Institutes of Health; 2011.

Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd