The Prevalence and Determinants of Undiagnosed and Diagnosed Type 2 Diabetes in Middle-Aged Irish Adults
METHODS: This was a cross-sectional study involving a sample of 2,047 men and women, aged between 50-69 years, randomly selected from a large primary care centre. Univariate logistic regression was used to explore socio-economic, metabolic and other health related variable associations with undiagnosed or diagnosed diabetes. A final multivariate analysis was used to determine odds ratios and 95% confidence intervals for having undiagnosed compared to diagnosed diabetes, adjusted for gender, age and significant covariates determined from univariate models.
RESULTS: The total prevalence of diabetes was 8.5% (95% CI: 7.4%-8.8%); 72 subjects (3.5%) had undiagnosed diabetes (95% CI: 2.8%-4.4%) and 102 subjects (5.0%) had diagnosed diabetes (95% CI: 4.1%-6.0%). Obesity, dyslipidaemia, and family history of diabetes were positively associated with both undiagnosed and diagnosed type 2 diabetes. Compared with diagnosed subjects, study participants with undiagnosed diabetes were significantly more likely to have low levels of physical activity and were less likely to be on treatment for diabetes-related conditions or to have private medical insurance.
CONCLUSIONS: The prevalence of diabetes within the Cork and Kerry Diabetes and Heart Disease Study is comparable to recent estimates from the SLÁN Survey of Lifestyle, Attitudes and Nutrition, a study which was nationally representative of the general population. A considerable proportion of diabetes cases were undiagnosed (41%), emphasising the need for more effective detection strategies and equitable access to primary healthcare.