“Pre-diabetes,” diabetes rising among U.S. teens

By 2008, 10 percent of teens had “pre-hypertension” - which means their blood pressure numbers were higher-than-normal, but not high enough to meet the definition of hypertension. Another three percent had full-blown high blood pressure.

When it came to LDL cholesterol, six percent of teens had high levels and 13 percent were borderline-high in 2008.

Those figures were similar to the ones almost a decade earlier. Pre-diabetes/diabetes was the exception.

There are limitations to the study, May’s team acknowledges. One is that they gauged pre-diabetes and diabetes from a single blood sugar measurement - which may be less reliable in kids than in adults.

Still, May said the “big message” here is that children and teenagers need more help with following a healthy diet and staying physically active.

What is the prevalence of diabetes by gender?
- 13.0 million men have diabetes (11.8 percent of all men ages 20 years and older).
- 12.6 million women have diabetes (10.8 percent of all women ages 20 years and older).

What is the prevalence of diagnosed and undiagnosed diabetes by age?
- 25.6 million Americans ages 20 or older have diabetes - 11.3 percent of this age group.
- 10.9 million Americans ages 65 and older have diabetes - 26.9 percent of this age group.

That’s the general way of managing pre-diabetes, May said, and it’s also the key to overall health, for both heavy and normal-weight kids.

In this study, pre-diabetes/diabetes and other heart risk factors were more common in overweight or obese teens. But their normal-weight peers were far from immune.

Of those thinner kids, 37 percent had at least one heart risk factor, May pointed out.

“All kids can benefit from a healthy lifestyle,” May said.

For parents, she said, that means “modeling” healthy eating and exercise for their kids, and making sure the kitchen is stocked with foods like fruits, vegetables, whole grains and low-fat dairy - rather than junk food.

May also said that pediatricians should be following guidelines on obesity screening.

What is Pre-Diabetes?
People who develop type 2 diabetes may be first diagnosed with pre-diabetes. Pre-diabetes means that your blood glucose levels are higher than normal, but lower than if you have type 2 diabetes. Pre-diabetes is also called impaired glucose tolerance or impaired fasting glucose.

If you have been diagnosed with pre-diabetes, then you have an increased risk for developing type 2 diabetes.

What are the Risk Factors?

A family history of diabetes and abdominal obesity can put you at higher risk of developing pre-diabetes. These are also some of the risk factors for type 2 diabetes. Lowering your risk of pre-diabetes now will help to prevent or delay type 2 diabetes later.

The U.S. Preventive Services Task Force, a government-backed panel, recommends that children age six and older be screened for obesity. If a child is heavy, pediatricians should offer families behavioral counseling, or refer them to someone who can.

The American Academy of Pediatrics (AAP) recommends that children have their blood pressure checked regularly starting around age four. The AAP also suggests that kids’ cholesterol be checked between the ages of nine and 11, and then again between the ages of 17 and 21.

SOURCE: Pediatrics, online May 21, 2012.

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Prevalence of Cardiovascular Disease Risk Factors Among US Adolescents, 1999−2008

RESULTS: Among the US adolescents aged 12 to 19 years, the overall prevalence was 14% for prehypertension/hypertension, 22% for borderline-high/high low-density lipoprotein cholesterol, 6% for low high-density lipoprotein cholesterol (

<35 mg/dL), and 15% for prediabetes/diabetes during the survey period from 1999 to 2008. No significant change in the prevalence of prehypertension/hypertension (17% and 13%) and borderline-high/high low-density lipoprotein cholesterol (23% and 19%) was observed from 1999–2000 to 2007–2008, but the prevalence of prediabetes/diabetes increased from 9% to 23%. A consistent dose-response increase in the prevalence of each of these CVD risk factors was observed by weight categories: the estimated 37%, 49%, and 61% of the overweight, obese, and normal-weight adolescents, respectively, had at least 1 of these CVD risk factors during the 1999 through 2008 study period.

CONCLUSIONS: The results of this national study indicate that US adolescents carry a substantial burden of CVD risk factors, especially those youth who are overweight or obese.
Ashleigh L. May, MS, PhD, Elena V. Kuklina, MD, PhD, and Paula W. Yoon, ScD, MPH

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