Introduction: Individuals with prediabetes (preDM) are at increased risk of developing type 2 diabetes and cardiovascular disease. Awareness and perceived risk of disease are key factors impacting lifestyle interventions. This study examined the prevalence, awareness, and perceived risk of preDM.

Methods: This nationally representative cross-sectional analysis of 2005-2018 National Health and Nutrition Examination Survey data was conducted on nonpregnant adults (aged≥20 years) . PreDM was based on fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) definitions recommended by the American Diabetes Association. We used fasting sample weight to generate nationally representative estimates. Measures also include sociodemographic, awareness, and perceived risk for DM or preDM. Analyses were accounted for the complex sample design and performed using Stata 17.

Results: Overall, among 15,968 adults, the weighted prevalence of PreDM increased from 31.5% (95%CI 28.5-34.4) in 2005-20to 47.2% (95% CI 43.7-50.7) in 2017-2018 with a significant linear trend (p<;0.001) . The weighted prevalence of awareness of preDM increased yearly from 5.6% in 20- 20to 12.6% in 2017-2018 based on FPG/HbA1c definition (p<;0.001) . Similarly, among those with preDM, the perceived risk increased from 28.2% in 20- 20to 32.9% in 20- 20 and plateaued at 36.9% in 2017-2018 without a significant linear trend (p=0.142) . Black and Mexican Americans had a higher prevalence of preDM than White. Education was positively associated with awareness and perceived risk, but the income was not. Women were less likely to have preDM but more likely to be aware of preDM than men. Overweight/obesity, hypertension, and depression were positively associated with preDM, awareness, and perceived risk.

Conclusions: Findings suggest that from 20to 2018, the prevalence of preDM continues to rise. More national efforts are needed to raise awareness of diabetes risk and target those at higher risk.


A.Yan: None. Z.Shi: None.

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