Wang Li, Weng Xingran, Kraschnewski Jennifer L, Pichardo-Lowden Ariana R
Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania.
AJPM Focus. 2025 Jun 6;4(5):100378. doi: 10.1016/j.focus.2025.100378. eCollection 2025 Oct.
Prediabetes is prevalent and commonly progresses to diabetes when unaddressed. Prediabetes progression is preventable, yet prediabetes unawareness jeopardizes timely intervention. This study examines barriers and enablers of prediabetes awareness, and describes its influence on diet and physical activity.
We used the United States National Health and Nutrition Examination Survey 2011-2020 data to identify participants with prediabetes. Weighted logistic regression identified factors associated with prediabetes awareness. Weighted logistic and linear regression tested the effects of prediabetes awareness on lifestyle choices such as sugar, carbohydrate and calorie consumption, and physical activity.
Of the 2,749 adult participants identified as having prediabetes, 84% were unaware of their condition. Having had a glucose testing in the previous three years before participating in the survey was the strongest independent contributor of prediabetes awareness (AOR: 3.97, 95% CI: 2.76-5.71, P<0.0001). Prediabetes awareness was associated with weight loss intent (AOR: 1.63, 95% CI: 1.13-2.33, p<0.01), but not with healthy lifestyle choices. Healthcare professionals' advice was associated with increased exercise (AOR: 1.75, 95% CI: 1.31-2.33, p<0.01), however, not with a change in diet.
Most participants were unaware of their prediabetes condition, regardless of social determinants of health and demographic factors. This suggests the need to promote prediabetes awareness across populations. Proactively evaluating and discussing results may help narrow the unawareness chasm. Lifestyle choices not being associated with prediabetes awareness suggests that mere awareness and medical advice are not enough for patients to embrace healthy behaviors.
糖尿病前期很常见，如果不加以治疗，通常会发展为糖尿病。糖尿病前期的进展是可以预防的，但对糖尿病前期的忽视会危及及时干预。本研究探讨了糖尿病前期知晓的障碍和促成因素，并描述了其对饮食和身体活动的影响。
我们使用2011 - 2020年美国国家健康与营养检查调查数据来识别患有糖尿病前期的参与者。加权逻辑回归确定了与糖尿病前期知晓相关的因素。加权逻辑回归和线性回归测试了糖尿病前期知晓对生活方式选择的影响，如糖、碳水化合物和卡路里的摄入量以及身体活动。
在2749名被确定患有糖尿病前期的成年参与者中，84%的人不知道自己的病情。在参与调查前的三年中进行过血糖检测是糖尿病前期知晓的最强独立促成因素（调整后比值比：3.97，95%置信区间：2.76 - 5.71，P<0.0001）。糖尿病前期知晓与减肥意愿相关（调整后比值比：1.63，95%置信区间：1.13 - 2.33，p<0.01），但与健康的生活方式选择无关。医疗保健专业人员的建议与增加运动相关（调整后比值比：1.75，95%置信区间：1.31 - 2.33，p<0.01），然而，与饮食变化无关。
大多数参与者不知道自己患有糖尿病前期，无论其健康的社会决定因素和人口统计学因素如何。这表明需要在人群中提高对糖尿病前期的认识。积极评估和讨论结果可能有助于缩小认知差距。生活方式选择与糖尿病前期知晓无关，这表明仅仅知晓和医疗建议不足以促使患者采取健康行为。
