Study Finds Prediabetes More Common Among Adolescents and Young Adults

Nearly one in five adolescents aged 12 to 18 years, and one in four young adults aged 19 to 34 years, are living with prediabetes, according to a new study published in JAMA Network.

“Prediabetes was even more common among youth and young adults with obesity. Prediabetes is a health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes,” says study lead author Linda Andes, PhD, National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, CDC, in Atlanta. “The condition puts people at increased risk of developing type 2 diabetes, chronic kidney disease, heart disease, and stroke.”

For the study, CDC researchers used data from the National Health and Nutrition Examination Survey. (NHANES) is a cross-sectional, nationally representative survey that includes household interviews, standardized medical examinations, plus blood sample collections in mobile examination centers. Data came from six two-year cycles of NHANES surveys (2005 to 2006 through 2015 to 2016). The study included participants between 12 to 34 years of age who had fasted for eight to 24 hours and had valid results for fasting plasma glucose (FPG), 2hr PG, and A1c tests. Of these, 2,606 were adolescents between the ages of 12 to 18; and 3,180 were young adults between the ages of 19 to 34.

The study was conducted to expand the pool of available research on prediabetes in adolescents and young adults, researchers examined IFG, IGT, and increased glycated hemoglobin in US adolescents (aged 12 to 18) and young adults (aged 19 to 34 years) without diabetes. Monitoring the number of young adults and adolescents with prediabetes and varying levels of glucose tolerance can help determine the future risk of type 2 diabetes in youth.

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“In order to reduce the impact of prediabetes in youth, clinicians can help by measuring children’s weight, and body mass index routinely, assessing their risk for prediabetes, and testing the child for prediabetes if appropriate,” Andes says. “Providers should also refer families into nutrition education or childhood and youth healthy weight programs as needed.”

Researchers also found significant differences in many of the metabolic indicators. A larger percentage of young adults had waist to height ratios greater than 0.5, indicating higher levels of abdominal fat, and had higher” bad” cholesterol as compared to adolescents.  Adolescents also had higher fasting insulin levels and were less insulin sensitive than young adults. 

Additionally, researchers found very little overlap among IFG, IGT, and increased A1c, indicating that prediabetes prevalence can be impacted by the method used to identify it.  

“For instance, consistent with similar studies in adults, females were more likely to have impaired glucose tolerance than males, though this difference was not statistically significant,” Andes says. “Similarly, consistent with previous research, black adolescents and young adults had higher rates of increased A1c compared to Hispanic and white adolescents and young adults.”