A shocking new study from the the medical journal JAMA Pediatrics has found that a whopping 28% of U.S. adolescents meet diagnostic criteria for prediabetes, raising questions about the adequacy of current screening guidelines and prevention methods.
The study analyzed data collected from ten cycles of the National Health and Nutrition Examination Survey in youth ages 12-19 between the years 1999 and 2018. Researchers found a steep rise in prediabetes over this time period, from 11.6% to 28.2% overall.
While older adolescents (16-19), males, and teens with obesity were more likely to have prediabetes, the number of cases rose steadily over the time period studied in adolescents of all genders, races, and weights.
"These numbers are striking, and it's pretty clear that, if we don't do something to bring down these numbers, we are going to see a significant increase in diabetes in the United States," study co-author Junxiu Liu tells UPI.
Notably, the data were all collected before the pandemic. Given that children, like adults, have been documented to have gained weight on average during the pandemic, and that there’s been a recorded increase in sedentary behavior and poor changes in diet, too, it’s reasonable to assume that, if measured today, the number of prediabetes cases in adolescents would be even higher.
A diagnosis of prediabetes means that a person is more likely to develop type 2 diabetes. The good news is that prediabetes can be treated — and diabetes avoided — with changes in diet and exercise as well as with weight loss.
This study used A1C levels and fasting glucose to diagnose prediabetes in study participants. Researchers did not include a glucose tolerance test — which you may remember as a horribly sweet orange drink you were made to ingest at some point during your pregnancy.
The A1C test, also known as HbA1c, measures your average blood sugar levels over the past two or three months. A1C up to 5.7% is considered normal. Prediabetes is defined as levels between 5.7-6.4%, while diabetes is defined as an A1C of 6.5% or over.
The study used a fasting blood glucose level of 100-125 to diagnose prediabetes.
During the years studied, 1999-2018, prediabetes in males rose from 15.8% to 36.4%. In females, it rose from 7.1% to 19.6%. For adolescents who were underweight or whose weight was normal, the rates went from 9.41% to 24.3%. In overweight teens, it went from 15.3% to 27.5%, and in obese adolescents, from 18.2% to 40.4%.
The rise among younger adolescents, ages 12-15, was 13.1%-30.8%. In comparison, the rate in older adolescents, ages 16-19, went from 10.0% to 25.6%.
The American Diabetes Association reports that lifestyle modifications, such as changes in diet and exercise, are more successful in delaying the onset of diabetes than Metformin, a medication used to control blood sugar.
Almost 100 million American adults (about one in three) also have the signs of prediabetes — so it’s not like we’re faring any better than our teens are.
Why are our numbers so high, and why do they continue to increase so steeply? While it’s easy to point fingers at individuals who aren’t eating right or exercising enough, a lot of our issues are likely systematic — like unhealthy school lunches, slashed physical education programs, urban food deserts, and low wages. Not to mention a healthcare system that doesn’t look out for kids or focus on prevention. It’s clear that we have lots of changes to make, on both the individual and societal levels.