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Prediabetes Now Common Among Teens and Young Adults

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Specializes in Clinical Leadership, Staff Development, Education. Has 28 years experience.

Why is Prediabetes Now Rising in Youth?

A new study, published in the journal JAMA Pediatrics, found 1 in 5 adolescents are now prediabetic.  Read on to learn more about the study and why rates for Type 2 diabetes is rising among American youth.

Prediabetes Now Common Among Teens and Young Adults

According to a new study recently published in JAMA Pediatrics, nearly a quarter of U.S. young adults and 1 in 5 adolescents are now prediabetic. Until recently, young children and teens were rarely diagnosed with type 2 diabetes (adult-onset diabetes). Today, about one-third of American kids are overweight, a risk factor closely linked to adult-onset diabetes.

What is Prediabetes?

Prediabetes is when blood glucose levels are higher than normal, but are not yet high enough for a type 2 diabetes diagnosis. The American Diabetes Association provides these guidelines for identifying prediabetes:

  • A1C of 5.7% to 6.4%
  • Fasting blood sugar of 100-125mg/dl
  • An OGTT 2 hour blood sugar of 140-199mg/dl

Most people do not know they are prediabetic, which further increases their risk for developing type 2 diabetes, heart disease and stroke.

Key Study Findings

Nearly 5,800 participants in a national health survey were studied from 2005 to 2016. The study used several tests to determine prediabetes, including fasting glucose, glucose tolerance or hemoglobin A1c. Key study findings include:

  • 18% of adolescents aged 12-18 were prediabetic
  • 24% of young adults aged 19-24 were prediabetic
  • Prediabetes was higher in males and participants with obesity
  • Hispanic young adults had higher rates of prediabetes than white young adults
  • Prediabetic teens and young adults had significantly higher:
    • Cholesterol levels
    • Systolic blood pressure
    • Abdominal fat and lower insulin sensitivity

** Above increases risk of other cardiovascular diseases

Risk Factors

It is not fully understood why some children develop type 2 diabetes and others don’t, even when risk factors are present in both. However, research clearly identifies factors increasing the risk. These include:

  • Weight- Being overweight is the primary risk factor
  • Inactivity
  • Family history
  • Race (being African-American, Hispanic, Native American, Asian-American and Pacific Islanders
  • Low birth weight
  • Mother had gestational diabetes

Age is also a risk factor with most youth being diagnosed with type 2 diabetes in their early teens. This is because hormones associated with puberty interfere with the body’s use of insulin.

More Complications with Type 2 Versus Type 1 Diabetes

Youth with type 2 diabetes are more likely to develop complications than youth with type 1, according to the SEARCH for Diabetes Youth study. Researchers found type 2 diabetics are more likely to develop kidney, nerve and eye diseases with the following statistics:

  • Nearly 20% developed signs of kidney disease vs 6% of type 1.
  • Approximately 18% developed nerve disease vs 9% with type 1
  • Approximately 9% developed eye disease vs 6% with type 1
  • Hypertension and arterial stiffness greater in type 1

What Can Be Done?

The study findings support the need for public health initiatives that promote healthy lifestyle changes to reduce the risk of type 2 diabetes. Research shows that adults with prediabetes can reduce their risk of developing type 2 diabetes by 58% with healthy lifestyle changes. Parents can help reduce the risk for children and teens by encouraging healthy eating habits and support increasing physical activity. The CDC’s Healthy Weight website offers parents on ideas for helping children maintain a healthy weight and stay active. For more information, visit CDC Tips for Parents - Ideas to Help Children Maintain a Healthy Weight.

The CDC also offers the National Diabetes Prevention Program to provide education to help prevent or delay type 2 diabetes for those aged 18 and older. The program features trained lifestyle coaches who encourage healthy lifestyle changes that include improved nutrition, physical activity and coping mechanisms to reduce stress. For more information, visit CDC National Diabetes Prevention Program.

The Role of Local Organizations

State and local organizations can help address the rising rates of prediabetes in their communities by:

  • Supporting mothers who choose to breastfeed
  • Working with early education centers and schools to improve the nutrition value of food served and provide opportunities for kids to be physically active.
  • Making healthy food easier to access and afford.
  • Keeping communities safe so youth can bike, walk and play

How have you seen obesity impact the health of children and teens in your area of practice? Did the results of this study surprise you?

J. Adderton MSN has over 20 years experience in clinical leadership, staff development, project management and nursing education.

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21 Comment(s)

Jedrnurse, BSN, RN

Specializes in school nurse. Has 29 years experience.

Schools have cut down recess time and PE classes and still use withholding of recess as a disciplinary tool. All bad and counter-productive ideas. Many people know this.

But it continues...

yupnv80, BSN, RN

Specializes in Med/Tele/IMCU. Has 4 years experience.

Not surprising since Health At Every Size movement have been plastered all over the media for a few years now. It’s easier to say nothing’s wrong instead of making meaningful changes in health and weight

Until we as nurses and doctors, as well as a society, accept that increased sugar consumption leads directly to metabolic conditions like diabetes, this "trend" will inevitably continue. It's amazing yet not shocking that ultra processed food containing sugar is left out of the risk factors. That's some lobby they have there.

As a first step, what's needed is mass education.

hannahgb

Specializes in retire-numerous. Has 47 years experience.

Normasaline--we have been educated to death--time to put that education into practice--"not enough time" is the answer to use of fast food use and riding everywhere---If the total life style practices don't change there is no hope

8 hours ago, hannahgb said:

Normasaline--we have been educated to death--time to put that education into practice--"not enough time" is the answer to use of fast food use and riding everywhere---If the total life style practices don't change there is no hope

I disagree.

I do not see billboards, online ads, TV ads (that would be HUGE) equating fast food with being hooked up to an IV in the hospital as the outcome. That is the blunt message I'm talking about. It needs to be done on a mass scale. You know it (I'm assuming); I know it, but does everyone know if you consume years worth of Starbucks, Burger King etc., that you may well end up on dialysis? No. I honestly do not think enough people know this. In order for more ease of doctor-patient communication and patient receptivity, a mass education is very supportive for the medical personnel. It's step one.

Finally, I re-iterate my point about ultra processed foods being left out of the risk factors. I'll say it again: that is some lobby they have there.

J.Adderton, BSN, MSN

Specializes in Clinical Leadership, Staff Development, Education. Has 28 years experience.

21 hours ago, NormaSaline said:

Finally, I re-iterate my point about ultra processed foods being left out of the risk factors. I'll say it again: that is some lobby they have there.

Such a great point. I recently read interesting article on how dollar stores, like Dollar General, are contributing to chronic disease. The reason- low cost, highly processed foods.

Just now, J.Adderton said:

It's so obvious that it almost goes without saying.

Sedentary lifestyle, consuming excessive sugars more than their body can utilize and store, and lazy around the house---doesn't do exercises such as vacuuming, sweeping, or tidying bedroom, or anything that involves physical activity then complain why they can't breathe after a few minutes moderate jogging. They certainly can play all day long no problem with their dumbphones and/or watch TV. Their favorite TV programs glamourizing extra weight around their waistline as curves. Being slender is seen as a sign of some sort of luxury. I can understand when it's due to health issues. Eat darn celery and some protein and other essential nutrients for a while.
We'll see if you still gain too much weight.

In short, hey, for them, it's their body. We can sit here and wait for them to learn from their own mistakes. I hope they'll change their perspective about quality of life. I just mind my own business; they're good for business.

Blame their parents. I'm sure they have some time to camp in front of the TV for more than 60 minutes a day. How about they ration at least 30 minutes per day at the playground with their kids?

Edited by Megarline
add info and grammar.

BostonFNP, APRN

Specializes in Adult Internal Medicine. Has 10 years experience.

We need to look past the trees and take a glance at the forest. One of the first things I ask my NP students to tell me when I teach about diabetes is: here in the US, what do all the risk factors have in common?

brownbook

Has 36 years experience.

Yes, there's too much processed food consumption and not enough plain old walking to school and being physically active at recess.

It's been known since 2015 from studies of mice that soybean oil causes a resistance to insulin.

Of course most fast food french fries are cooked in oils containing soy beans.

We're doomed 😢.

HandsOffMySteth

Has 3 years experience.

On 12/21/2019 at 3:21 AM, NormaSaline said:

Until we as nurses and doctors, as well as a society, accept that increased sugar consumption leads directly to metabolic conditions like diabetes, this "trend" will inevitably continue. It's amazing yet not shocking that ultra processed food containing sugar is left out of the risk factors. That's some lobby they have there.

As a first step, what's needed is mass education.

Not too long ago there was a movement to have food manufacturers indicate if a product had GMOs. The huge corporations dumped a fortune into lobbying and ended up winning. I guess it's none of our business what we eat!?

I don't know how schools are now, but there were soda machines in all the schools in the recent past. I wonder what deals were made with the education system to put them there.

I also think that the obesity epidemic from fast food has much to do with the prediabetes issue

Edited by juniper222

BostonFNP, APRN

Specializes in Adult Internal Medicine. Has 10 years experience.

18 hours ago, juniper222 said:

Not too long ago there was a movement to have food manufacturers indicate if a product had GMOs.

This has nothing to do with GMOs. Labeling food GMO is a marketing ploy nothing more.

HandsOffMySteth

Has 3 years experience.

1 hour ago, BostonFNP said:

This has nothing to do with GMOs. Labeling food GMO is a marketing ploy nothing more.

My point was to show how the industry manipulates policy. I do not state whether GMOs are harmful or not. Industry dumped a lot of money into preventing the bill from passing. They also advertise fast food. Corporations plainly do not want the unhealthy contents of food known to us. All of these things are important to keep in mind when looking into the issue of prediabetes.

The rest of my post show a correlation between the schools and soda machines. Who do you think would be behind putting those there?

BostonFNP, APRN

Specializes in Adult Internal Medicine. Has 10 years experience.

On 1/18/2020 at 7:03 PM, juniper222 said:

Corporations plainly do not want the unhealthy contents of food known to us.

We agree that the consuming public needs to know what is healthy and what is not on the ingredient label, however, GMO or non-GMO has nothing to do with what is healthy/unhealthy.

The most important thing to consider as clinicians is what all of the risk factors for IGT/T2GM have in common.

I am not sure the jury is completely in on GMO products so I try not to make sweeping statements either way. For now, and speaking personally, I appreciate knowing that if something's labeled organic it is also non-GMO.

On 1/17/2020 at 3:54 PM, brownbook said:

Yes, there's too much processed food consumption and not enough plain old walking to school and being physically active at recess.

Quote

It's been known since 2015 from studies of mice that soybean oil causes a resistance to insulin.

How do they study these mice? How do they control their diet and exercise? If feeding mice with soybean oil without any other nutrition, they get sick from it. And any animal can get sick from a single diet that's not growing in such an environment. Or, it's the excess weight that is the primary risk factor of insulin insensitivity or the pancreas ceases to produce insulin or both.

Do we see any fat people in a country where foods are problems? I'm sure it has something to do with excess food consumption than the body can burn.

[Perhaps, individuals really have to start thinking of their own health and stop focusing on body image or curves. Check the social media where people bicker that their excess fats are certainly sexy and curvy. Any man or woman will love him or her even with extra unnecessary body fats. That "love" doesn't care about our health or shape. Many people enslave or ruin themselves for love.]

I'm sure, for some people, they're feeding their food pleasure center and overeating.

Edited by Megarline

brownbook

Has 36 years experience.

Megarline, I really appreciate your question. It is good to question studies and statistics. This is how research and knowledge advances.

I am not very good with computers, how to insert other media, etc., Below is just the first part of the original article from PLOS. The actual study/article is many pages long so I just copied the opening part.

You are welcome to Google the article (I couldn't read the whole article I get crossed eyed looking at statistics and graphs etc.!) and see if your question is answered.

PLoS One. 2015; 10(7): e0132672.

Published online 2015 Jul 22. doi: 10.1371/journal.pone.0132672

PMCID: PMC4511588

PMID: 26200659

Soybean Oil Is More Obesogenic and Diabetogenic than Coconut Oil and Fructose in Mouse: Potential Role for the Liver

Poonamjot Deol, 1 Jane R. Evans, 1 Joseph Dhahbi, 2 Karthikeyani Chellappa, 1 , ¤ Diana S. Han, 1 Stephen Spindler, 2 and Frances M. Sladek 1 ,*

Jonathan Peterson, Editor

Author information Article notes Copyright and License information Disclaimer

This article has been cited by other articles in PMC.

Associated Data

Supplementary Materials

Data Availability Statement

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Abstract

The obesity epidemic in the U.S. has led to extensive research into potential contributing dietary factors, especially fat and fructose. Recently, increased consumption of soybean oil, which is rich in polyunsaturated fatty acids (PUFAs), has been proposed to play a causal role in the epidemic. Here, we designed a series of four isocaloric diets (HFD, SO-HFD, F-HFD, F-SO-HFD) to investigate the effects of saturated versus unsaturated fat, as well as fructose, on obesity and diabetes. C57/BL6 male mice fed a diet moderately high in fat from coconut oil and soybean oil (SO-HFD, 40% kcal total fat) showed statistically significant increases in weight gain, adiposity, diabetes, glucose intolerance and insulin resistance compared to mice on a diet consisting primarily of coconut oil (HFD). They also had fatty livers with hepatocyte ballooning and very large lipid droplets as well as shorter colonic crypt length. While the high fructose diet (F-HFD) did not cause as much obesity or diabetes as SO-HFD, it did cause rectal prolapse and a very fatty liver, but no balloon injury. The coconut oil diet (with or without fructose) increased spleen weight while fructose in the presence of soybean oil increased kidney weight. Metabolomics analysis of the liver showed an increased accumulation of PUFAs and their metabolites as well as γ-tocopherol, but a decrease in cholesterol in SO-HFD. Liver transcriptomics analysis revealed a global dysregulation of cytochrome P450 (Cyp) genes in SO-HFD versus HFD livers, most notably in the Cyp3a and Cyp2c families. Other genes involved in obesity (e.g., Cidec, Cd36), diabetes (Igfbp1), inflammation (Cd63), mitochondrial function (Pdk4) and cancer (H19) were also upregulated by the soybean oil diet. Taken together, our results indicate that in mice a diet high in soybean oil is more detrimental to metabolic health than a diet high in fructose or coconut oil.

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Introduction