A new study in the July issue of The Journal of the American Medical Association, Dr. Andy Menke and colleagues estimated the prevalence of diabetes among U.S. adolescents, the percentage of those who were unaware of their diabetes, and the prevalence of prediabetes and found the numbers higher than previously thought.
According to the study, one in five American teenagers has an abnormal glucose level, according to new government data.
Of 2,606 adolescents included, 62 had diabetes, 20 were undiagnosed, and 512 had prediabetes. The weighted prevalence of diabetes was 0.8 percent, of which 29 percent was undiagnosed, and the prevalence of prediabetes was 18 percent. Prediabetes was more common in males (22 percent) than females (13 percent).
Higher rates in minority teens
Both prediabetes and undiagnosed diabetes were more common in male, non-Hispanic black, and Hispanic teens compared with females and non-Hispanic whites.
However, Dr Menke noted, “Our study was not designed to identify risk factors for undiagnosed diabetes or prediabetes in adolescents. Further research needs to be conducted to better identify those adolescents who will benefit from diabetes screening.”
In the interim, he said, “physicians may need to better screen the youth at high risk for diabetes based on the guidelines for their adult counterparts and to educate people on the risk factors for type 1 and type 2 diabetes.”
Compared with non-Hispanic white participants, the percentage of adolescents with diabetes who were undiagnosed (4.6 percent) and the prediabetes prevalence (15 percent) were higher in non-Hispanic black participants (50 percent and 21 percent, respectively) and Hispanic participants (40 percent and 23 percent, respectively). Diabetes and prediabetes prevalences did not change over time.
Most comprehensive report
According to the study it is the first that makes comprehensive use of all three ADA standards.
“To our knowledge, these are the first estimates of diabetes in a nationally representative sample of U.S. adolescents using all 3 American Diabetes Association recommended biomarkers. The estimates are higher than previously reported; 1 study found diagnosed diabetes in 0.34 percent of participants aged 10 to 19 years. A relatively large proportion was unaware of the condition, particularly among non-Hispanic black participants and Hispanic participants, indicating a need for improved diabetes screening among adolescents. These findings may have important public health implications because diabetes in youth is associated with early onset of risk factors and complications.”
Dr. Menke told Medscape Medical News that although study participants who reported insulin use were more likely to have type 1 diabetes while those who did not use insulin were more likely to have type 2 diabetes, “there are exceptions for both, so we can’t consider insulin use to be accurate criteria to determine diabetes type. Likewise, weight-for-height criteria are not well-established for adolescents and also vary within types of diabetes. This is indeed an area where further research is necessary.”