'Prediabetes' common in U.S. teens, young adults

(Reuters Health) – About one in five teens and one in four young adults in the U.S. have slightly elevated blood sugar, sometimes known as “prediabetes,” that can lead to full-blown diabetes, a study suggests.

For the study, researchers examined data on blood sugar levels for 5,786 people ages 12 to 34 who hadn’t been diagnosed with diabetes. Overall, 18% of the younger people in the study, ranging in age from 12 to 18 years old, had “prediabetes,” as did 24% of the adults 19 to 34 years old.

“Prediabetes is highly prevalent in U.S. adolescents and young adults, especially in male individuals and in people with obesity,” lead study author Linda Andes of the U.S. Centers for Disease Control and Prevention in Atlanta and colleagues write in JAMA Pediatrics.

These teens and young adults with prediabetes are at increased risk not only for developing type 2 diabetes – the common form of the disease associated with obesity and aging – but also cardiovascular problems that can lead to heart attacks and strokes, the study team writes.

“These findings together with the observed increase in the prevalence of type 2 diabetes in U.S. adolescents and in diabetes-related complications in young adults highlight the need for … prevention efforts tailored to the young segment of the U.S. population,” the study team notes.

Average blood sugar levels over the course of about three months can be estimated by measuring a form of hemoglobin that binds to glucose in blood, known as A1c. Hemoglobin A1c levels of 6.5% or above signal diabetes.

Levels between 5.7% and 6.4% are considered elevated, though not yet diabetic, while 5.7% or less is considered normal.

Overall, 5.3% of teens and 8% of young adults in the study had levels in this “prediabetic” range, the study found.

To get a more complete picture of how many young people might be at risk for developing full-blown diabetes, researchers also looked at other things including so-called insulin resistance, or the body’s failure to respond normally to the hormone insulin. Diabetes can develop when the body can’t properly use insulin to convert blood sugar into energy.

They also looked at what’s known as impaired fasting glucose, when blood sugar levels are above a normal range but not quite high enough to formally diagnose diabetes.

Both teens and young adults in the study who appeared to have prediabetes had higher cholesterol and blood pressure and more fat stored around their midsections than individuals without prediabetes.

Among teens in the study, about 23% of males had prediabetes, compared with 13% of females. Differences persisted among young adults: 29% of males and 19% of females had prediabetes.

And, less than 16% of white teens had prediabetes, compared with more than 22% of black and Hispanic adolescents. This difference also carried through to early adulthood: about 21% of white people had prediabetes compared with 27% of black individuals and 29% of Hispanic young adults.

People with obesity were also most likely to have prediabetes: 26% of teens and 37% of young adults with obesity had this condition.

The study wasn’t a controlled experiment designed to prove whether or how markers of prediabetes might directly lead to diabetes in teens or young adults.

One limitation of the study is that researchers only had data to assess prediabetes at a single point in time, the study authors note.

SOURCE: JAMA Pediatrics, online December 2, 2019.


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