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04-12-2019 | Diabetes | News | Article

NHANES uncovers scale of prediabetes problem in US youth

medwireNews: A US survey suggests nearly one in five adolescents and one in four young adults has prediabetes and that the condition is linked to an unfavorable cardiometabolic risk profile.

The researchers say these young people are therefore at risk for both type 2 diabetes and cardiovascular disease and they urge studies to assess whether lifestyle modification can prevent or delay type 2 diabetes in the same way that it has in primary prevention trials among high-risk adults.

Prediabetes was particularly common in males and obese participants, note Linda Andes (Centers for Disease Control and Prevention, Atlanta, Georgia, USA) and colleagues in JAMA Pediatrics.

The findings from the 2005–2016 National Health and Nutrition Examination Survey showed that 18.0% of the 2606 adolescent participants aged 12 to 18 years had prediabetes, as did 24.0% of the 3180 young adults aged 19 to 34 years.

Participants were classified as having prediabetes if they had one of three phenotypes of glucose metabolic dysregulation: impaired fasting glucose (IFG), defined as fasting plasma glucose level of between 100 and less than 126 mg/dL; impaired glucose tolerance with a 2-hour plasma glucose level of between 140 and less than 200 mg/dL, or increased glycated hemoglobin (HbA1c) levels of between 5.7% and less than 6.5%.

IFG was the most prevalent of the three phenotypes and there was little overlap among the subgroups, the researchers report.

For example among the 11.1% of 12- to 18-year-olds with IFG, 9.2% had isolated IFG. For those aged 19 to 34 years, the corresponding values were 15.8% and 11.4%.

Prediabetes was almost twice as prevalent in male as female participants, both in the younger age group (22.5 vs 13.4%) and the older one (29.1 vs 18.8%) and this was driven by IFG being at least twice as common in males as females.

Prediabetes was also much more common among obese participants compared with those who were normal or underweight, both in the 12–18 year age group (25.7 vs 16.4%) and the 19–34 year age group (36.9 vs 16.6%).

The 12-year survey data also show that adolescents and young adults with prediabetes have significantly higher non-high-density lipoprotein cholesterol levels, systolic blood pressure, and central adiposity, as well as lower insulin sensitivity than those with normal glucose tolerance.

The researchers conclude: “These findings together with the observed increase in the prevalence of type 2 diabetes in US adolescents and in diabetes-related complications in young adults highlight the need for primary and secondary prevention efforts tailored to the young segment of the US population.”

By Anita Chakraverty

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

JAMA Pediatr 2019; doi:10.1001/jamapediatrics.2019.4498

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