Academic Journal

Clinical performance and health equity implications of the American Diabetes Association’s 2023 screening recommendation for prediabetes and diabetes

التفاصيل البيبلوغرافية
العنوان: Clinical performance and health equity implications of the American Diabetes Association’s 2023 screening recommendation for prediabetes and diabetes
المؤلفون: Matthew J. O’Brien, Yan Zhang, Stacy C. Bailey, Sadiya S. Khan, Ronald T. Ackermann, Mohammed K. Ali, Michael E. Bowen, Stephen R. Benoit, Giuseppina Imperatore, Christopher S. Holliday, Kai McKeever Bullard
المصدر: Frontiers in Endocrinology, Vol 14 (2023)
بيانات النشر: Frontiers Media S.A., 2023.
سنة النشر: 2023
المجموعة: LCC:Diseases of the endocrine glands. Clinical endocrinology
مصطلحات موضوعية: diabetes screening, prediabetes screening, health equity, racial and ethnic disparities, sex and gender disparities, population health, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
الوصف: IntroductionThe American Diabetes Association (ADA) recommends screening for prediabetes and diabetes (dysglycemia) starting at age 35, or younger than 35 years among adults with overweight or obesity and other risk factors. Diabetes risk differs by sex, race, and ethnicity, but performance of the recommendation in these sociodemographic subgroups is unknown.MethodsNationally representative data from the National Health and Nutrition Examination Surveys (2015-March 2020) were analyzed from 5,287 nonpregnant US adults without diagnosed diabetes. Screening eligibility was based on age, measured body mass index, and the presence of diabetes risk factors. Dysglycemia was defined by fasting plasma glucose ≥100mg/dL (≥5.6 mmol/L) or haemoglobin A1c ≥5.7% (≥39mmol/mol). The sensitivity, specificity, and predictive values of the ADA screening criteria were examined by sex, race, and ethnicity.ResultsAn estimated 83.1% (95% CI=81.2-84.7) of US adults were eligible for screening according to the 2023 ADA recommendation. Overall, ADA’s screening criteria exhibited high sensitivity [95.0% (95% CI=92.7-96.6)] and low specificity [27.1% (95% CI=24.5-29.9)], which did not differ by race or ethnicity. Sensitivity was higher among women [97.8% (95% CI=96.6-98.6)] than men [92.4% (95% CI=88.3-95.1)]. Racial and ethnic differences in sensitivity and specificity among men were statistically significant (P=0.04 and P=0.02, respectively). Among women, guideline performance did not differ by race and ethnicity.DiscussionThe ADA screening criteria exhibited high sensitivity for all groups and was marginally higher in women than men. Racial and ethnic differences in guideline performance among men were small and unlikely to have a significant impact on health equity. Future research could examine adoption of this recommendation in practice and examine its effects on treatment and clinical outcomes by sex, race, and ethnicity.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1664-2392
Relation: https://www.frontiersin.org/articles/10.3389/fendo.2023.1279348/full; https://doaj.org/toc/1664-2392
DOI: 10.3389/fendo.2023.1279348
URL الوصول: https://doaj.org/article/4d40988c06d4475fbc2ff90980310e12
رقم الانضمام: edsdoj.4d40988c06d4475fbc2ff90980310e12
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:16642392
DOI:10.3389/fendo.2023.1279348