1 in 5 adolescents in US are prediabetic, condition goes undetected for years until severe problems show up

The condition, which also affects 1 in 4 young adults, can lead to type 2 diabetes, heart disease and stroke.


                            1 in 5 adolescents in US are prediabetic, condition goes undetected for years until severe problems show up

Prediabetes is a serious health condition where blood sugar levels are higher than normal, but it often goes undetected for years until major problems such as type 2 diabetes crop up, say experts. And latest estimates show that prediabetes is highly common in the US, affecting about one in five adolescents and one in four young adults.

“We estimated the overall prevalence of prediabetes to be about one in five for adolescents aged 12 to 18 years, and one in four for young adults aged 19 to 34 years,” says the research team from the US Centers for Disease Control and Prevention (CDC).

According to experts from the CDC and the American Diabetes Association, there are no clear symptoms of prediabetes, so a person may not even know for years that he or she has the condition. 

Having prediabetes, explains CDC, implies that a person’s blood glucose or sugar levels are higher than normal, but not high enough to be diagnosed as diabetes. What is clear, say experts, is that people with prediabetes do not process sugar properly anymore. Prediabetes can lead to heart disease, stroke and type 2 diabetes, the most common form of diabetes, say experts. 

The CDC says until recently, young children and teenagers rarely got type 2 diabetes, which is why it used to be called adult-onset diabetes. Now, about one-third of American youth are overweight, a problem closely related to the increase in children with type 2 diabetes, some as young as 10 years old.

“Over 84 million Americans now have prediabetes – that’s 1 out of 3 adults. Of those 84 million, nine out of 10 of them don’t even know they have it. Without taking action, many people with prediabetes could develop type 2 diabetes within five years,” says CDC.

The CDC says that until recently, young children and teens rarely got type 2 diabetes, which is why it used to be called adult-onset diabetes. Now, about one-third of American youth are overweight, a problem closely related to the increase in children with type 2 diabetes, some as young as 10 years old. (Getty Images)

In a previous study, researchers from the Emory Rollins School of Public Health and CDC had reported that high proportions of patients with prediabetes are at substantial risk for cardiovascular disease and chronic kidney disease. The analysis shows that having high glucose levels is associated with a much higher risk of high blood pressure, high cholesterol, and an increased risk of having a heart attack in the next 10 years. Additionally, over 11% of people with prediabetes have some type of kidney dysfunction, which is an early predictor that in the next 10-15 years, they may need to go on dialysis or receive a kidney transplant, according to the study published in Lancet Diabetes and Endocrinology. 

Experts from the American Diabetes Association say that before people develop type 2 diabetes, they almost always have prediabetes. 

“You may have some of the symptoms of diabetes or even some of the complications. Check with your doctor and get tested. If you discover that you do have prediabetes, remember that it doesn’t mean you’ll develop type 2, particularly if you follow a treatment plan and a diet and exercise routine. Even small changes can have a huge impact on managing this disease or preventing it altogether,” says the Association.

While prediabetes generally has no signs or symptoms, experts say a possible sign that a person is at risk of type 2 diabetes is darkened skin on certain parts of the body. The neck, armpits, elbows, knees, and knuckles could be affected. 

“Classic signs and symptoms that suggest you have moved from prediabetes to type 2 diabetes include increased thirst, frequent urination, fatigue and blurred vision,” say Mayo Clinic experts

While the exact cause of prediabetes is not known, family history and genetics appear to play an important role. People who are inactive and those who are overweight, especially if they have excess belly fat, are also at risk. 

The experts say one can prevent or delay prediabetes from developing into type 2 diabetes with simple, proven lifestyle changes, which includes losing a modest amount of weight and regular physical activity. Individuals can also take an online prediabetes risk test developed by CDC. 

People who are at risk for prediabetes. (Source: CDC)

In the current study, CDC experts examined data from the National Health and Nutrition Examination Surveys (NHANES) from 2005-2006 to 2015-2016. The final analysis consisted of 5,786 participants. Of these, 2,606 (45%) were adolescents aged 12 to 18 years, and 3,180 (55%) were young adults aged 19 to 34 years. The researchers found that among adolescents, the prevalence of prediabetes was 18%, while it was 24% among young adults.

The team also found that in adolescents and young adults, the prevalence of prediabetes in male individuals was almost twice than in female individuals. The analysis shows that the prevalence of prediabetes was significantly higher in male than in female individuals — 22.5% versus 13.4% in adolescents and 29.1% versus 18.8% in young adults. 

Prediabetes prevalence was significantly higher in individuals with obesity than in those with normal weight, 25.7% versus 16.4% in adolescents, and 36.9% versus 16.6% in young adults, say experts.

Prediabetes prevalence was significantly higher in individuals with obesity than in those with normal weight, 25.7% versus 16.4% in adolescents, and 36.9% versus 16.6% in young adults, shows analysis. (Getty Images)

“In this survey study of US adolescents and young adults, the prevalence of prediabetes was lower among adolescents than young adults. It was significantly higher in male than female individuals and in those with obesity,” says the study published in JAMA Pediatrics.

It says, “Obesity is a strong predictor of increased risk for type 2 diabetes in adults and probably also plays a major role in the development of the disease at younger ages. Obesity is highly prevalent among US adolescents and young adults. The finding that a large proportion of adolescents and young adults with obesity already present glucose metabolism abnormalities is of great public health concern given the sharp increase in type 2 diabetes in adolescence.” 

The researchers found that adolescents and young adults with prediabetes also present an “unfavorable cardiometabolic risk profile,” putting them both at increased risk of type 2 diabetes and cardiovascular diseases. 

The researchers explain as type 2 diabetes is projected to increase fourfold among US adolescents in the next decades, it is crucial to monitor the prevalence of prediabetes. This, says the team, will help assess the future risk of type 2 in the youngest segment of the population and guide prevention strategies.

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