D-15 Increase the proportion of persons with diabetes whose condition has been diagnosed

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Baseline (Year)
72.8 (2005-2008)
Target
80.1
Target-Setting Method
10 percent improvement
Numerator
Number of persons aged 20 years and older who report that they have ever been diagnosed with diabetes
Denominator
Number of persons aged 20 years and older who report that they have ever been diagnosed with diabetes plus the number of persons aged 20 years and older who have undiagnosed diabetes (a fasting blood glucose level greater or equal to 126 mg/dl or an HbA1c level greater or equal to 6.5)
Questions Used to Obtain the National Baseline Data

From the 2005-2008 National Health and Nutrition Examination Survey:

[NUMERATOR:]

{Other than during pregnancy, {have you/has SP}/{Have you/Has SP}} ever been told by a doctor or other health professional that {you have/{he/she/SP} has} diabetes or sugar diabetes?.

  • (1) Yes
  • (2) No
  • (3) Borderline or pre-diabetes
  • (7) Refused
  • (9) DK/Ns
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective

Comments

Methodology Notes

Persons are considered to have diagnosed diabetes if they respond “yes” to the question “have you ever been told by a doctor that you have diabetes.” Women who report that the only time they have been diagnosed with diabetes was during pregnancy (gestational diabetes) are excluded. Persons who report that they have pre-diabetes or borderline diabetes are counted as ‘no’. The undiagnosed population with diabetes is based on the American Diabetes Association criteria.

Data for HbA1c are available for the whole sample, but data for fasting glucose are only measured for the morning examination session. For these analysis the cohort examined is restricted to persons in the AM exam session only.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Disability Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Education Level: 25-49, 50-59, 60-69, 70-79, 80+
  • Race/Ethnicity: 20-49, 50-59, 60-69, 70-79, 80+
  • Family Income Level: 20-49, 50-59, 60-69, 70-79, 80+
  • Sex: 20-49, 50-59, 60-69, 70-79, 80+
  • Health Insurance Status: 20-49, 50-59, 60-64
  • Marital Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Veteran Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Country of Birth: 20-49, 50-59, 60-69, 70-79, 80+
  • Obesity Status: 20-49, 50-59, 60-69, 70-79, 80+
  • Total: 20-49, 50-59, 60-69, 70-79, 80+
Trend Issues
Hemoglobin A1c results for 2007-2008 (GHB_E) and 2009-2010 (GHB_F) were temporarily withdrawn in November 2011 to evaluate a shift to the right (increased values) in the distribution of Hemoglobin A1c in 2007-2010 compared to 1999-2006. After careful evaluation of participant data, laboratory quality control data and non-NHANES A1c studies, a cause for this shift in the distribution of Hemoglobin A1c could not be identified. Therefore, the Hemoglobin A1c data for 2007-2008 (GHB_E) and 2009-2010 (GHB_F) were re-released in March 2012 without changes to the data. The user will need to carefully consider the information presented in this analytic note when analyzing Hemoglobin A1c data from 1999-2010.
Changes Between HP2010 and HP2020
This objective tracks the same measure as HP2010 objective 5-4, however the ADA released new diabetes diagnosis criteria in the year 2010. For HP2010 undiagnosed diabetes was determined using fasting glucose levels, however for HP2020 undiagnosed diabetes is determined using both fasting glucose levels as well as A1c levels to follow the newest guidelines.