Just Read: Prevalence of Prediabetes Among Adolescents and Young Adults in the United States, 2005-2016 (it’s way too high)

This study has been widely shared already, with a significant degree of alarm.

Among adolescents, the prevalence of prediabetes was 18.0% (95% CI, 16.0%-20.1%) and among young adults was 24.0% (95% CI, 22.0%-26.1%) Andes LJ, Cheng YJ, Rolka DB, Gregg EW, Imperatore G. Prevalence of Prediabetes Among Adolescents and Young Adults in the United States, 2005-2016. JAMA Pediatr [Internet]. 2019 Dec 2 [cited 2019 Dec 4];e194498. Available from: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2755415

This is the definition of prediabetes. It may not look scary, but medically speaking, it’s terrifying for a person’s biology.

The American Diabetes Association has defined prediabetes as the presence of impaired fasting glucose (IFG; fasting plasma glucose [FPG] concentration between 100 mg/dL to <126 mg/dL; to convert to millimoles per liter, multiply by 0.0555), impaired glucose tolerance (IGT; a 2-hour plasma glucose [2hrPG] concentration after a 75-g oral glucose tolerance test of 140 mg/dL to 199 mg/dL), or glycated hemoglobin A1c (HbA1c) levels between 5.7% and 6.4% (to convert to proportion of total hemoglobin, multiply by 0.01).1 In adults, these 3 phenotypes increase the risk of developing type 2 diabetes2 as well as cardiovascular diseases. Andes LJ, Cheng YJ, Rolka DB, Gregg EW, Imperatore G. Prevalence of Prediabetes Among Adolescents and Young Adults in the United States, 2005-2016. JAMA Pediatr [Internet]. 2019 Dec 2 [cited 2019 Dec 4];e194498. Available from: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2755415

This is especially true since prediabetes is too prevalent even in youth and young adults who are normal weight or underweight.

2018.05 Low Carb and Low Carbon - Ted Eytan MD 2-1002 836
2018.05 Low Carb and Low Carbon – Ted Eytan MD 2-1002 836 (View on Flickr.com)

And it tracks other data that’s as alarming.

2018.05 Low Carb and Low Carbon - Ted Eytan MD 3-1003 837
2018.05 Low Carb and Low Carbon – Ted Eytan MD 3-1003 837 (View on Flickr.com)

The authors did not offer any reasons why they think this situation exists other than a rise in obesity rates. However, their data does not conclusively establish obesity as the cause.

Here are some additional ideas.

2018.05 Low Carb and Low Carbon - Ted Eytan MD 3-1003 795
2018.05 Low Carb and Low Carbon – Ted Eytan MD 3-1003 795 (View on Flickr.com)
2018.05 Low Carb and Low Carbon - Ted Eytan MD 4-1004 796
2018.05 Low Carb and Low Carbon – Ted Eytan MD 4-1004 796 (View on Flickr.com)
2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 803
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 803 (View on Flickr.com)

Should we worry? Yes. Is there a way out? Yes.

References

  1. Andes LJ, Cheng YJ, Rolka DB, Gregg EW, Imperatore G. Prevalence of Prediabetes Among Adolescents and Young Adults in the United States, 2005-2016. JAMA Pediatr [Internet]. 2019 Dec 2 [cited 2019 Dec 4];e194498. Available from: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2755415
  2. Babey SH, Wolstein J, Diamant AL, Goldstein H. Prediabetes in California: Nearly Half of California Adults on Path to Diabetes [Internet]. 2016. Available from: http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1472,UCLA Center for Health Policy Research, Copyright © 2006 The Regents of the University of California. All Rights Reserved
  3. Mokdad AH, Ballestros K, Echko M, Glenn S, Olsen HE, Mullany E, et al. The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States. JAMA [Internet]. 2018;319(14):1444–72. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2018.0158
  4. Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220

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