Racial/ethnic variation in prevalence estimates for United States prediabetes under alternative 2010 American Diabetes Association criteria: 1988-2008.

OBJECTIVE To compare the racial/ethnic variation in United States prediabetes prevalence estimates for alternative prediabetes definitions currently approved by the American Diabetes Association (ADA) across 20 years and in detailed multivariate comparisons. DESIGN Using nationally representative National Health and Nutrition Examination Survey (NHANES) data from 1988-2008, we compared trends in the prevalence of impaired fasting glucose (IFG) and impaired glycated hemoglobin (IGH) for non-Hispanic Black, non-Hispanic White, and Mexican American/other Hispanic adults. Using NHANES 2005-2008, we compared prevalence by race/ethnicity in more detail for the three current ADA prediabetes definitions--IFG, IGH, and impaired glucose tolerance (IGT)--controlling for associated factors (education, income, weight, age, sex). RESULTS Prediabetes prevalence during the last 20 years was consistently significantly lower among non-Hispanic Blacks compared to non-Hispanic Whites when measured by IFG, but was significantly higher among non-Hispanic Blacks when measured by IGH. In adjusted models, non-Hispanic Blacks were significantly more likely than non-Hispanic Whites to have IGH (OR: 2.22; 95% CI: 1.33-3.70) and less likely to have IFG (OR: 0.46; 0.30-0.73) or IGT (OR: 0.35; 0.24-0.50), but Mexican American/other Hispanic rates did not differ significantly from non-Hispanic White rates. However, rates of prediabetes, when defined by any of three individual diagnostic criteria, were not statistically significantly different across groups (36.8% for non-Hispanic Whites, 36.0% AA, 37.3% Mexican American/other Hispanics). CONCLUSIONS National prediabetes prevalence estimates vary dramatically across racial/ethnic groups according to diagnostic method, though over 35% in all three racial/ethnic groups met at least one ADA diagnostic criteria for prediabetes.