Judith Aponte, Department of Nursing, Hunter-Bellevue School of Nursing, Hunter College, City University of New York, New York, NY 10010, United State.
World J Diabetes. 2013 Dec 15;4(6):349-57. doi: 10.4239/wjd.v4.i6.349.
To investigate normoglycemic, prediabetic and diabetic A1c levels in those with prediabetes; and prediabetic and diabetic A1c levels in those with non-prediabetes.
The National Health and Nutritional Examination Survey (NHANES) 2007-2008 and NHANES 2009-2010 were utilized to examine and compare trends and differences among five different ethnic groups (Mexican Americans, Other Hispanics, Non-Hispanic Whites, Non-Hispanic Blacks, Other/Multi-racials) with normoglycemic, prediabetic and diabetic A1c levels with self-reported prediabetes and prediabetic and diabetic A1c levels in those with self-reported non-prediabetes. Sample participants of the five ethnic groups were limited to those 20 years of age and older, who had completed the diabetes questionnaire and had A1c measured. Descriptive statistics were computed for all variables. χ(2) were performed on all five ethnic groups to examine significant differences of normoglycemic, prediabetic and diabetic A1c levels in those with self-reported prediabetes, and prediabetic and diabetic A1c levels in those with self-reported non-prediabetes.
This study demonstrates that of the five different ethnic groups from NHANES 2007-2008 to NHANES 2009-2010, Non-Hispanic Whites (6.5% increase) and Non-Hispanic Blacks (0.2% increase) were the only two groups with an increase in the number of self-reported prediabetes. Although the overall percentage of Mexican Americans who self-reported prediabetes had remained the same (5%) from NHANES 2007-2008 to NHANES 2009-2010, χ(2) analysis showed significant differences when examining the different ranges of A1c levels (normoglycemic, prediabetic and diabetic). Among Mexican Americans who self-reported prediabetes, normoglycemic (P = 0.0001) and diabetic (P = 0.0001) A1c levels from NHANES 2007-2008 to NHANES 2009-2010. For Non-Hispanic Whites who self-reported prediabetes, prediabetic (P = 0.0222); and diabetic (P ≤ 0.0001) A1c levels from NHANES 2007-2008 to NHANES 2009-2010. For Non-Hispanic Blacks who self-reported prediabetes, there were significant differences (P = 0.0001) for all A1c levels (normoglycemic, prediabetic and diabetic A1c levels). For Other/Multi-racials with self-reported prediabetes there was significant differences in those with normoglycemic (P = 0.0104) and diabetic (P = 0.0067) A1c levels from NHANES 2007-2008 to NHANES 2009-2010. For all combined ethnic groups who self-reported not having prediabetes (non-prediabetes), 19.9% of those in NHANES 2007-2008 and 22.4% in the NHANES 2009-2010 showed to have prediabetic A1c levels. When separately examining each of the five ethnic groups who self-reported not having prediabetes, all showed an increase in those with prediabetic A1c levels from NHANES 2007-2008 to NHANES 2009-2010. Through χ(2) analysis, all five ethnic groups who self-reported not having prediabetes showed significant differences (P < 0.0001) in all A1c levels (normoglycemic, prediabetic and diabetic) from NHANES 2007-2008 to NHANES 2009-2010.
The findings highlight the need of prediabetes awareness and of education in the community as ways to reduce the number of people with prediabetes.
调查患有糖尿病前期人群的正常血糖、糖尿病前期和糖尿病 A1c 水平；以及非糖尿病前期人群的糖尿病前期和糖尿病 A1c 水平。
利用 2007-2008 年和 2009-2010 年全国健康和营养调查（NHANES）的数据，比较了五个不同种族（墨西哥裔美国人、其他西班牙裔、非西班牙裔白人、非西班牙裔黑人、其他/多种族裔）的正常血糖、糖尿病前期和糖尿病 A1c 水平，并与自我报告的糖尿病前期和自我报告的非糖尿病前期人群的糖尿病前期和糖尿病 A1c 水平进行了比较。将五个种族的样本参与者限制在年龄在 20 岁及以上、完成糖尿病问卷并测量 A1c 的人群。对所有变量进行了描述性统计。对所有五个种族进行了 χ²检验，以检查自我报告的糖尿病前期人群中正常血糖、糖尿病前期和糖尿病 A1c 水平，以及自我报告的非糖尿病前期人群中糖尿病前期和糖尿病 A1c 水平的显著差异。
本研究表明，在 2007-2008 年至 2009-2010 年的 NHANES 中，非西班牙裔白人和非西班牙裔黑人（分别增加了 6.5%和 0.2%）是仅有的两个自我报告糖尿病前期人数增加的种族。尽管从 2007-2008 年的 NHANES 到 2009-2010 年的 NHANES，墨西哥裔美国人自我报告糖尿病前期的比例保持不变（5%），但 χ²分析显示，在检查不同 A1c 水平（正常血糖、糖尿病前期和糖尿病）时，存在显著差异。在自我报告糖尿病前期的墨西哥裔美国人中，2007-2008 年 NHANES 至 2009-2010 年 NHANES 的正常血糖（P=0.0001）和糖尿病 A1c 水平（P=0.0001）均存在显著差异。对于自我报告糖尿病前期的非西班牙裔白人，糖尿病前期（P=0.0222）和糖尿病（P≤0.0001）A1c 水平也存在显著差异。对于自我报告糖尿病前期的非西班牙裔黑人，所有 A1c 水平（正常血糖、糖尿病前期和糖尿病 A1c 水平）均存在显著差异（P=0.0001）。对于自我报告糖尿病前期的其他/多种族裔人群，2007-2008 年 NHANES 至 2009-2010 年 NHANES 的正常血糖（P=0.0104）和糖尿病 A1c 水平（P=0.0067）存在显著差异。对于所有自我报告没有糖尿病前期的种族（非糖尿病前期），2007-2008 年 NHANES 中的 19.9%和 2009-2010 年 NHANES 中的 22.4%显示出糖尿病前期的 A1c 水平。当分别检查五个自我报告没有糖尿病前期的种族时，所有种族的糖尿病前期 A1c 水平都有所增加。通过 χ²分析，所有五个自我报告没有糖尿病前期的种族在 2007-2008 年 NHANES 至 2009-2010 年 NHANES 的所有 A1c 水平（正常血糖、糖尿病前期和糖尿病）中均存在显著差异（P<0.0001）。
这些发现强调了需要提高对糖尿病前期的认识和在社区进行教育，以减少糖尿病前期人群的数量。
