Diabetes and its complications are major causes of morbidity and mortality in the United States and contribute substantially to health-care costs. Data from the National Health Interview Survey (NHIS) and the Behavioral Risk Factor Surveillance System (BRFSS) have documented steady increases in the prevalence of diabetes (1,2). However, these surveys rely only on self-reports of previously diagnosed diabetes and cannot measure the prevalence of undiagnosed diabetes. The change in prevalence demonstrated by these data might reflect other factors such as enhanced detection rather than true increases. The National Health and Nutrition Examination surveys (NHANES) are the only nationally representative surveys that examine both diagnosed and undiagnosed diabetes. During 1976–1980 (NHANES II) and 1988–1994 (NHANES III), the overall combined prevalence of diabete
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