Perceived risk for diabetes among U.S. adults with undiagnosed prediabetes

The purpose was to examine the degree to which perceived risk for diabetes differed by race and ethnicity among U.S. adults with undiagnosed prediabetes. The study was a cross-sectional analysis of data from 4005 participants (aged ≥20 years) in the National Health and Nutrition Examination Survey (NHANES) program between 2011 and 2018. Individuals with prediabetes were identified using glycohemoglobin (HbA_1c) data. Logistic regression was used to estimate the association between race and ethnicity and perceived risk of diabetes while adjusting for age and sex, educational level, family history of diabetes, BMI, and healthcare factors (health insurance coverage and routine place to go for healthcare). Nearly three-quarters (71.8%) of adults with undiagnosed prediabetes reported no perceived risk for diabetes. Rates of perceived risk for diabetes did not change significantly in any racial and ethnic groups from 2011 to 12 to 2017-18. In models adjusted for individual characteristics, identifying as Non-Hispanic Black was associated with a 34% higher likelihood of reporting no perceived risk compared to identifying as Non-Hispanic White (OR 1.34, 95% CI:1.03-1.74). Identifying as Hispanic was associated with a 29% higher likelihood of reporting no perceived risk compared to identifying as Non-Hispanic White (OR 1.29, 95% CI: 1.01, 1.66). Healthcare factors may have less influence on diabetes risk perception. Future public health efforts should improve diabetes risk communication efforts across racial and ethnic groups, emphasizing Non-Hispanic Black and Hispanic populations.