The rate of prediabetes among youths ages 12 to 19 in the United States more than doubled over a 20-year period, according to a new study published in the journal JAMA Pediatrics.
Prediabetes refers to elevated blood glucose levels that aren’t high enough for a diagnosis of diabetes. It can be measured in a number of different ways — such as a fasting blood glucose test, an oral glucose tolerance test (OGTT), or an A1C test (a measure of long-term blood glucose control). There are conflicting views on how “serious” prediabetes should be considered, based on different study results. One study showed that among adults with prediabetes, relatively few went on to develop actual diabetes. But just having prediabetes has been linked to serious health problems in other studies, including a higher risk for major depression and a greater risk for cognitive decline.
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While a major task force recently recommended that screening for prediabetes and diabetes should begin as early as age 35, there is less consensus on how prediabetes should be managed or treated — beyond the usual lifestyle recommendations and seeing if a person develops diabetes. A recent study found that many health care providers aren’t very attentive to prediabetes, rarely offering follow-up care even if someone receives an official diagnosis — and a diagnosis often doesn’t even happen. The same task force also found that there isn’t enough evidence to recommend screening children and teenagers for prediabetes or type 2 diabetes.
Increases in prediabetes rates seen among youths
For the latest study, researchers looked at data on rates of prediabetes — based on recorded A1C levels — among over 6,500 youths ages 12 to 19 between 1999 and 2018. In the period of 1999-2002, the rate of prediabetes was 11.6%, as noted in an article on the study at MedPage Today. By 2015-2018, the rate had risen to 28.2%. The researchers found that prediabetes was clearly linked to obesity in this age group, although the rate of prediabetes rose in every category of body weight based on body-mass index (BMI, a measure of body weight that takes height into account). Among underweight or normal-weight youths, the prediabetes rate rose from 9.4% to 24.3%. Among overweight youths, the prediabetes rate rose from 15.3% to 27.5%. And in youths with obesity, the prediabetes rate rose from 18.2% to 40.4%.
Likewise, a dramatic increase in prediabetes was seen in all age groups among youths in the study. Among those ages 12-15, the prediabetes rate rose from 13.1% to 30.8%, and among those ages 16-19, the prediabetes rate rose from 10.0% to 25.6%. Prediabetes was more common among males than females — the rate rose from 7.1% to 19.6% among females, and from 15.8% to 36.4% among males.
While all three documented racial or ethnic groups in the study saw similar increases in the rate of prediabetes, the increase was largest among Black youths — with the prediabetes rate rising from 11.7% to 32.3%. Among white youths, the prediabetes rate rose from 11.5% to 26.8%, and in Hispanic youths, the prediabetes rate rose from 13.4% to 28.6%. Asian youths could not be looked at separately as a group in the analysis because of inconsistent data prior to 2011-2014.
The researchers found no consistent links between food security or parental education level and increases in prediabetes rates — in fact, a similar increase in prediabetes was seen across parental education levels. More research is needed, they wrote, to fully understand what’s behind this alarming increase in prediabetes among youths, which should ideally incorporate larger groups of participants and use measures other than just A1C to look for prediabetes or diabetes.
Want to learn more about prediabetes? Read “What Is Prediabetes? Symptoms, Treatment, and More,” “Prediabetes Treatment” and “Diabetes Prevention: Eat to Beat Diabetes.”