Diabetes detection is far better than previous estimates

Diabetes can have major consequences for the health and quality of life of affected people, especially when left undiagnosed. Fortunately, doctors are able to diagnose the vast majority of patients, who can then receive treatment.

But a minority may have diabetes for a long time without knowing they have the disease. These patients consequently don't reap the benefit of medications or recommendations for various lifestyle changes that can reduce the symptoms and risks associated with diabetes. But fortunately fears are abating as diabetes is being detected far more often.

"Earlier European studies have estimated that around 22 to 25% of the people who have diabetes don't know they have it. However, the International Diabetes Association estimates as many as 41% of the individuals with diabetes in Europe have not yet been diagnosed," says Vera Vik Bjarkø, a doctor and Ph.D. candidate at NTNU's Department of Public Health and Nursing.

Only half as many undiagnosed in Norway

The situation is more positive in Norway, according to a recent study that included responses from almost 53,000 people.

"About 11% of individuals who have diabetes had not been diagnosed yet," said Bjarkø, the first author of the study which has been published in the journal Diabetic Medicine.

This percentage is only half as large as European professionals had feared.

"This finding indicates that our approach to detecting people with diabetes is working well," says Bjarkø.

This is encouraging news both for individuals who can get help once diagnosed and for the Norwegian health service.

Diagnosed patients do better

Finding out whether you have diabetes is important. The list of risk factors is long.

"Compared to people with normal blood values, people who remain undiagnosed or prediabetic have a higher BMI, larger waist measurement, higher systolic blood pressure, more of the unfavorable fats called triglycerides and larger amounts of proteins that indicate inflammation in the body," says Bjarkø.

These combined factors increase the risk of serious ailments and mortality, especially of cardiovascular disease. People who are diagnosed are often better able to manage these risks.

"People who have diabetes but who haven't yet been diagnosed, have less favorable values for all risk factors compared with people who have been diagnosed," says Bjørn Olav Åsvold. He is a professor at the HUNT Research Center and an endocrinologist at St. Olavs Hospital, as well as the senior author of the recent study.

Researchers collected the data by by going through the Trøndelag Health Study (HUNT). This gigantic database includes more than 240,000 people who have participated since the start of the survey in 1994. The fourth round of data collection, HUNT4, was completed in 2019.

Of the 52,856 participants in this round, approximately 6% had diabetes, which was about as expected. Eighty-nine percent of this group had already been diagnosed. The researchers identified the rest by measuring the blood value of the diabetes marker HbA1c in the participants.