Three in 10 adults with diabetes remain undiagnosed, revealing a need for care improvements.

Researchers from Emory’s Rollins School of Public Health created a  ‘cascade of care’ model, patterned after a similar model used to address implementation gaps in HIV care, for visualizing gaps in awareness of diagnosis, engagement and treatment of diabetes. The cascade of care concept is a method of showing how many patients are living with a certain condition and how many are receiving the care and treatment that they need to manage that condition.

“This concept has been used to monitor and address the HIV/AIDS epidemic, and has provided insight into the continuum of care and where gaps in care occur for that disease, explains Mohammed Ali, MBChB, MSc, assistant professor in the Hubert Department of Global Health and the Department of Epidemiology at Emory’s Rollins School of Public Health.

Ali and team analyzed data from the National Health and Nutrition Examination Survey (NHANES) to create a cascade of care for diabetes. Over the five years studied, an estimated 28.4 million adults, or 11.8 percent of the adult population, in the U.S. ages 18 and older had diabetes and 7.9 million reported being unaware of their condition, even though 85 percent of them were linked to a care provider. Sixty-seven percent visited care providers at least twice during the preceding year.

Complete findings are published in Annals of Internal Medicine (http://www.annals.org/article.aspx?doi=10.7326/M14-0019).