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Diabetes Affects 1 in 6 US Adults: CDC Data

In a stark reflection of diabetes screening gaps, more than one-quarter of U.S. adults with diabetes remained undiagnosed in 2021-2023, with obesity linked to a nearly four-fold higher prevalence compared to normal-weight individuals.

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Nearly 16% of US adults had diabetes during August 2021-August 2023, with approximately 28.5% of cases being undiagnosed, according to new data from the National Health and Nutrition Examination Survey. The study found diagnosed diabetes affected 11.3% of adults, while undiagnosed diabetes impacted 4.5%.

Men demonstrated significantly higher rates of both total diabetes (18.0%) and diagnosed diabetes (12.9%) compared with women (13.7% and 9.7%, respectively). The difference in undiagnosed diabetes between sexes was not statistically significant.

Age-stratified analysis revealed increasing prevalence with age. Among adults aged 20-39 years, only 2.2% had diagnosed diabetes and 1.3% had undiagnosed diabetes. For ages 40-59, diagnosed diabetes rose to 12.1% and undiagnosed to 5.6%. In those 60 and older, diagnosed diabetes reached 20.5% and undiagnosed 6.8%.

Weight status showed strong associations with prevalence rates. Among those with normal or underweight BMI (<25), total diabetes prevalence was 6.8%. For overweight individuals (BMI 25-29.9), prevalence increased to 12.3%. Those with obesity (BMI ≥30) showed a prevalence of 24.2%.

Educational attainment demonstrated an inverse relationship with diabetes prevalence. Adults with a high school degree or less showed 19.6% total diabetes prevalence. Those with some college education had 17.2% prevalence, and those with a bachelor's degree or higher showed prevalence at 10.7%.

The age-adjusted prevalence of total diabetes increased from 9.7% in 1999-2000 to 14.3% in August 2021-August 2023. Diagnosed diabetes similarly increased from 5.9% to 10.1% during this period. The prevalence of undiagnosed diabetes remained statistically unchanged, moving from 3.8% to 4.2%.

The study used American Diabetes Association diagnostic criteria, including 8- to 24-hour fasting plasma glucose measurements ≥126 mg/dL or hemoglobin A1c ≥6.5%. The survey excluded pregnant women and used fasting sample weights to account for differential probabilities of selection, nonresponse, and noncoverage.

No conflicts of interest were disclosed in the report.