Diabetes and prediabetes: screening and prevalence among adults with coronary heart disease

Abstract

Background: Clinical performance measures recommend that nondiabetic patients with coronary heart disease (CHD) be screened for diabetes every 3 years.

Purpose: The purpose of this study is to report the prevalence of diabetes and prediabetes among U.S. adults aged ≥35 years with CHD and to determine factors associated with not receiving recommended diabetes screenings.

Methods: The Behavioral Risk Factor Surveillance System (BRFSS) is an annual state-based telephone survey of non-institutionalized U.S. adults. Information on prediabetes prevalence was collected for 33 states in 2008; data analysis was conducted in 2009. The prevalence of diabetes and prediabetes among adults aged ≥35 years with CHD (n=20,618) and prevalence of diabetes screening among nondiabetic adults with CHD (n=14,335) were assessed. Multivariate logistic regression was used to calculate the odds of not being screened for diabetes in the past 3 years while controlling for other factors.

Results: Among adults with CHD, 30.7% (95% CI=29.4%, 32.1%) reported being diagnosed with diabetes and 10.0% (95% CI=9.2%, 10.8%) reported prediabetes. Among nondiabetic adults with CHD, 25.4% (95% CI=23.9%, 26.9%) reported not being screened for diabetes in the past 3 years. Those with no recent routine checkup and those with no health insurance had the highest odds of no recent diabetes screening.

Conclusions: The prevalence of diabetes and prediabetes is substantial among adults with CHD and likely underestimated because of suboptimal screening. One of four nondiabetic adults with CHD reported not being screened for diabetes in the past 3 years.