Trends in the prevalence of cardiometabolic diseases in US adults with newly diagnosed and undiagnosed diabetes, 1988-2020.

Objectives: Early detection and timely management of cardiometabolic diseases (CMDs) in diabetes are critical for preventing vascular complications and premature mortality. However, the prevalence of CMDs over time in adults with newly diagnosed and undiagnosed diabetes is unclear.

Study Design: Cross-sectional study.

Methods: Included were US adults aged ≥20 years with newly diagnosed diabetes and undiagnosed diabetes using data from the National Health and Nutrition Examination Survey in 1988-2020. CMDs included obesity, severe obesity, dyslipidemia, hypertension, metabolic dysfunction-associated fatty liver disease (MAFLD), chronic kidney disease (CKD), and cardiovascular disease (CVD). Poisson regressions were used to assess trends in the prevalence of CMDs and to compare the prevalence between newly diagnosed and undiagnosed diabetes.

Results: For both diabetes phenotypes in 1988-2020, the prevalence of obesity and severe obesity increased and CKD decreased (P < 0.05). The prevalence of dyslipidemia decreased and MAFLD increased in undiagnosed diabetes (P < 0.05). In 2011-2020, the prevalence of CMDs ranged from 14.3 % for CVD to 78.6 % for dyslipidemia. No significant difference in the prevalence of all CMDs between the 2 diabetes phenotypes was observed.

Conclusions: The prevalence of CMDs remained high in US adults with newly diagnosed and undiagnosed diabetes during the previous 3 decades, with no significant difference in the prevalence between the 2 diabetes phenotypes.