Perceived risk of diabetes seriously underestimates actual diabetes risk : The KORA FF4 study
Objective
Early detection of diabetes and prediabetic states is beneficial for patients, but may be
delayed by patients' being overly optimistic about their own health. Therefore, we assessed
how persons without known diabetes perceive their risk of having or developing diabetes,
and we identified factors associated with perception of diabetes risk.
Research design and methods
1,953 participants without previously known diabetes from the population-based, German
KORA FF4 Study (59.1 years, 47.8% men) had an oral glucose tolerance test. They estimated
their probability of having undiagnosed diabetes mellitus (UDM) on a six category
scale, and assessed whether they were at risk of developing diabetes in the future. We
cross-tabulated glycemic status with risk perception, and fitted robust Poisson regression
models to identify determinants of diabetes risk perception.
Results
74% (95% CI: 65-82) of persons with UDM believed that their probability of having undetected
diabetes was low or very low. 72% (95% CI: 69-75) of persons with prediabetes
believed that they were not at risk of developing diabetes. In people with prediabetes, seeing oneself at risk of diabetes was associated with self-rated poor general health (prevalence
ratio (PR) = 3.1 (95% CI: 1.4-6.8), parental diabetes (PR = 2.6, 1.9-3.4), high educational
level (PR = 1.9 (1.4-2.5)), lower age (PR = 0.7, 0.6±0.8, per 1 standard deviation increase),
female sex (PR = 1.2, 0.9-1.5) and obesity (PR = 1.5, 1.2-2.0).
Conclusions
People with undiagnosed diabetes or prediabetes considerably underestimate their probability
of having or developing diabetes. Contrary to associations with actual diabetes risk,
perceived diabetes risk was lower in men, lower educated and older persons.
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