In the United States, prediabetes occurs in about 1 in 5 adolescents and 1 in 4 young adults, according to study results published in JAMA Pediatrics.
The results also indicated that the prevalence of prediabetes is higher among males and individuals with obesity.
The study included adolescents and young adults (N=5786) aged 12 to 34 years who participated in the 2005 to 2006 and 2015 to 2016 National Health and Nutrition Examination Surveys (NHANES) who were not pregnant and did not have diabetes. Included patients had data recorded for fasting plasma glucose, 2-hour plasma glucose concentration after a 75-g oral glucose tolerance test, and hemoglobin A1c (HbA1c) levels.
The researchers defined impaired fasting glucose (IFG) as fasting plasma glucose of 100 mg/dL to <126 mg/dL, impaired glucose tolerance (IGT) as 2-hour plasma glucose of 140 mg/dL to <200 mg/dL after the tolerance test, and increased HbA1c as HbA1c level between 5.7% and 6.4%. They then estimated the prevalence of these characteristics and prediabetes overall (defined as having IFG, IGT, or increased HbA1c level), as well as cardiometabolic risk factors and insulin sensitivity in these groups.
Overall, 45% (n=2606) of patients were adolescents and 55% (n=3180) were young adults. The prevalence of prediabetes was 18.0% (95% CI, 16.0%-20.1%) among adolescents and 24.0% (95% CI, 21.9%-26.1%) among young adults.
The results indicated that IFG made up the largest proportion of prediabetes distribution, present in 11.1% (95% CI, 9.5%-13.0%) of adolescents and 15.8% (95% CI, 14.0%-17.9%) of young adults.
Using multivariable logistic models that adjusted for age, sex, race/ethnicity, and body mass index, the researchers found that the prevalence of prediabetes was significantly higher among males compared with females (22.5% [95% CI, 19.8%-25.4%] vs 13.4% [95% CI, 10.8%-16.5%] in adolescents and 29.1% [95% CI, 26.4%-32.1%] vs 18.8% [95% CI, 16.5%-21.3%] in young adults).
Individuals with obesity were also significantly more likely to have prediabetes compared with individuals who had normal weight in both age groups.
With regard to cardiovascular risk factors and insulin sensitivity, adolescents and young adults with prediabetes had significantly higher non-high-density lipoprotein cholesterol levels and systolic blood pressure and lower insulin sensitivity compared with those with normal glucose tolerance (all P <.05).
“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,” the researchers wrote.
Andes LJ, Cheng YJ, Rolka DB, Gregg EW, Imperatore G. Prevalence of prediabetes among adolescents and young adults in the United States, 2005-2016 [published online December 2, 2019]. JAMA Pediatr. doi:10.1001/jamapediatrics.2019.4498