Recent national data reveals that approximately 1 in 3 young people aged 12 to 17 are affected by prediabetes, placing them at significant risk for serious health issues such as type 2 diabetes, heart disease, and stroke. The development of chronic diseases at a young age not only raises the likelihood of progression to more severe health conditions but also leads to poorer health outcomes over time. Experts have indicated that this alarming trend is primarily a reflection of the rising obesity rates among teenagers. However, it is important to note that not every adolescent diagnosed with prediabetes will ultimately develop diabetes.
The insightful report from the Centers for Disease Control and Prevention (CDC) was guided by data from the long-established National Health and Nutrition Examination Survey (NHANES). The survey assessed adolescents regarding any prior diabetes diagnoses and analyzed their fasting blood glucose levels and hemoglobin A1c test results. According to the findings, as of 2023, an estimated 8.4 million adolescents—or 32.7% of those aged 12 to 17—are living with prediabetes. Christopher Holliday, director of the CDC’s Division of Diabetes Translation, emphasized that these figures serve as a wake-up call regarding the health risks posed by type 2 diabetes among the youth. Fortunately, he noted that it is not too late to alter this trajectory through simple lifestyle changes, such as adopting healthy eating habits and maintaining regular physical activity.
While changes in data collection methods complicate direct comparisons, applying the current methodology to previous estimates suggests that the prevalence of prediabetes among adolescents was around 28% during the 2015-2016 period, a significant increase from earlier estimates, which hovered closer to 20%. The data used in this recent report was gathered from two distinct time frames: 2017 through March 2020 and August 2021 through August 2023.
This upward trend in prediabetes prevalence among young individuals is corroborated by research from the National Institutes of Health and aligns with a resurgence in diabetes diagnoses among adults aged 18 and older. After experiencing a decline for over a decade, adult diabetes rates are now on the rise again, with roughly 1.5 million new diabetes diagnoses recorded in 2023, according to the latest CDC data.
As emphasized by Meg Bensignor, a pediatric endocrinologist at the University of Minnesota, not every child with prediabetes will progress to type 2 diabetes. However, factors such as a higher Body Mass Index (BMI) or hemoglobin A1c levels at diagnosis, coupled with weight gain and adverse social determinants of health, significantly increase the risk. Bensignor noted the critical stress on the pancreas and beta cells in children with prediabetes, which can lead to faster deterioration of beta cell function compared to adults. “Given the current landscape, I generally approach treatment with the assumption that these children are likely to develop type 2 diabetes due to the severe health implications it brings,” she said.
Dr. Nancy Crimmins, a pediatric endocrinologist from Cincinnati Children’s Hospital Medical Center, highlighted the uncertainty surrounding which adolescents with prediabetes will transition to type 2 diabetes. Historical NHANES data suggests that approximately 70% of youths with prediabetes may revert to normal glycemic measures after puberty, with other studies indicating a range between 45% and 75% for similar reversion rates. “The disparity between the number of adolescents diagnosed with prediabetes and those who actually develop type 2 diabetes is striking,” Crimmins remarked.
Crimmins further explained that puberty plays a significant role in prediabetes development. Increased insulin resistance during this period, fueled by growth hormones and other hormonal changes, contributes to the heightened risk. She reaffirmed that type 2 diabetes in children is an aggressive condition that warrants preventive measures. Bensignor pointed out that the CDC report does not differentiate between the types of diabetes, which is critical for devising effective prevention strategies. Type 2 diabetes, characterized by the pancreas's inability to produce sufficient insulin, is fundamentally distinct from type 1 diabetes, where the immune system attacks insulin-producing cells.
The American Diabetes Association recommends screening for children aged 10 and above who have a BMI above the 85th percentile for their age and at least one additional risk factor, such as a family history of type 2 diabetes or maternal gestational diabetes. Additionally, social determinants of health, including limited access to nutritious food and opportunities for physical activity, significantly impact these statistics, especially among nonwhite children. Physical examinations can reveal early signs of insulin resistance, such as skin changes that indicate excessive insulin production.
As the medical community continues to grapple with this emerging phenomenon, experts like Bensignor and Crimmins stress the need for ongoing research. The NIH-funded DISCOVERY trial aims to identify which children with prediabetes are likely to progress to type 2 diabetes. “This data reinforces the urgent need for scientific funding and research to better understand treatment and prevention strategies for children,” Bensignor concluded. “We require more comprehensive studies to effectively address the rising incidence of type 2 diabetes among youth.”
