National survey estimates prevalence of type 2 diabetes among adolescents

An estimated 39,000 U.S. adolescents may have type 2 diabetes and more than 2.5 million may have impaired fasting glucose levels, which could lead to diabetes and other health problems, according to a study in the May issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

About 18.2 million U.S. citizens have diabetes, including 210,000 individuals younger than age 20 years, according to background information in the article. Type 2 diabetes, which occurs when the body cannot use the insulin that it manufactures to break down glucose in the body, is considered an emerging problem among this age group. Studies also indicate that impaired glucose tolerance, a blood glucose level that is higher than normal but not high enough for a diagnosis of diabetes, is common among young people who are overweight and can lead to the development of diabetes.

Glen E. Duncan, Ph.D., R.C.E.P.S.M., University of Washington, Seattle, used data from a national survey of the U.S. population to determine the prevalence of diabetes and impaired fasting glucose levels (which measure blood sugar after an eight-hour fast to detect impaired glucose tolerance) among U.S. adolescents. A total of 4,370 participants aged 12 to 19 (mean age 15.4) years were asked whether they had ever been told by a physician that they had diabetes. A subsample of 1,496 adolescents who responded "no" had their glucose levels testing after fasting overnight.

Of the 4,370 original participants, 18 or 0.5 percent had diabetes; of those, about 71 percent had type 1 diabetes and 29 percent had type 2 diabetes. About 11 percent, or 178, of the subsample without diabetes had impaired fasting glucose levels. When considered as a sample of the entire population of U.S. adolescents, these numbers are equivalent to 134,071 individuals age 12 to 19 years with diabetes, 39,005 with type 2 diabetes and 2,769,736 with impaired fasting glucose levels.

"The prevalence of type 2 diabetes and impaired fasting glucose levels is substantial among U.S. adolescents," Dr. Duncan concludes.

"These estimates have important implications for public health because of the high rate of conversion from impaired fasting glucose level to type 2 diabetes in adults and the increased risk of cardiovascular disease in individuals with type 2 diabetes."

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(Arch Pediatr Adolesc Med. 2006;160:523-528. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was funded by a career development award from the National Institutes of Health.

Editorial: Testing, Intervention Required for High-Risk Teens

More frequent blood glucose and lipid testing may be necessary in certain adolescents to detect and prevent the development of diabetes and its cardiovascular complications, writes Arlan L. Rosenbloom, M.D., Children's Medical Services Center, Gainesville, Fla., in an accompanying editorial.

Those children who are overweight or at risk for being overweight "are going to require the kind of monitoring for cardiovascular risk factors that has been considered standard of care for older adults," Dr. Rosenbloom writes. "The costs of this monitoring are insignificant in comparison to the potential for prevention of early cardiovascular disease, but only if there are individual and community resources to effect lifestyle change, and if necessary, maintain compliance with medications" for risk factors such as high blood pressure and high cholesterol.

"It is to be hoped that the recognition of the public health time bomb reflected in the report by Dr. Duncan will lead to a pervasive societal effort to prevent obesity, a daunting task of such magnitude that enormous community and governmental commitments will be required," Dr. Rosenbloom concludes.

(Arch Pediatr Adolesc Med. 2006;160:550-552. Available pre-embargo to the media at www.jamamedia.org.)

To contact editorialist Arlan L. Rosenbloom, M.D., call April Frawley Birdwell at 352-273-5817.


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