Prevalence of diabetes and impaired glucose metabolism in younger ‘at risk’ UK adults: insights from the STAND programme of research

Abstract

Rising rates of obesity have led to an increasing prevalence of Type 2 diabetes mellitus in young people. Uncertainty exists over the utility of screening younger adults for Type 2 diabetes, as existing data sets have focused on mature (> 40 years) cohorts. The aim of this study was to determine the prevalence of impaired glucose metabolism in higher risk younger adults. Overweight (with an additional risk factor) or obese adults (18-40 years) were recruited for the Sedentary Time And Diabetes (STAND) randomized controlled trial. Measures included an oral glucose tolerance test, HbA1c , biochemical and anthropometric data. One hundred and ninety-three individuals (68% female; median age 33.8 years; median BMI 33.9 kg/m²) were recruited. Forty-three per cent had a first-degree family history of Type 2 diabetes. Previously undiagnosed Type 2 diabetes was present in 4.7% (n = 9). Of participants, 18.1% (n = 35) had impaired glucose metabolism: 4.7% (n = 9) HbA1c ≥ 48 mmol/mol (6.5%); 9.3% (n = 18) HbA1c 42-46 mmol/mol (6.0-6.4%); 3.1% (n = 6) Type 2 diabetes on oral glucose tolerance test; 6.2% (n = 12) isolated impaired glucose tolerance; 2.1% (n = 4) isolated impaired fasting glucose; 1% (n = 2) both impaired fasting glucose and impaired glucose tolerance. Of participants, 58.5% (n = 113) had dyslipidaemia, 28.0% (n = 54) had hypertension, 31.1% (n = 60) were vitamin D deficient and 7.3% (n = 14) had abnormal liver function. This study identified a high prevalence of Type 2 diabetes and impaired glucose regulation in overweight and obese younger adults. These findings require confirmation in a larger, representative, population.