Background: Population-based rates of prediabetes or dysglycaemia (i.e. elevated A1C) among low-risk youth are not well described. Moreover, the biological and socioeconomic determinants of an elevated A1C in youth remain poorly understood. Methods: Youth aged 6-19 years who participated in the first (2007-2009) or second (2009-2011) cycles of the Canadian Health Measures Survey (CHMS) were included in our analyses. The primary outcome, dysglycaemia was defined using A1C guidelines established by the American Diabetes Association (ADA: 5.7%-6.4%) and Canadian Diabetes Association (CDA: 6.0%-6.4%). Various biological and socioeconomic determinants were compared between healthy and dysglycaemic youth using two sample t-tests and χ 2 tests (Table 1). Multivariable logistic regression was used to calculate adjusted odds ratios for dysglycaemia. Age stratified regression was performed to adjust for physical activity. All analyses were unweighted. Results: Of the 3449 youth studied, 785 (22.8%) and 179 (5.2%) displayed dysglycaemia according to ADA and CDA definitions, respectively. Youth with dysglycaemia (ADA definition) were more likely to be male (55.4 v 50.6%, p=0.02), non-white (24.8 v 14.6%, p<0.001) and obese (16.2 v 10.8%, p<0.001). Dysglycaemia in youth was more common in those living in households with middle income adequacy (32.6 v 26.8%, p=0.006) and lower levels of parental education (high school or less, 15 vs 11.4%, p=0.007). Similar associations were found using CDA definition. In the adjusted logistic regression model (age ≥12y), significant predictors were age, race, income adequacy, geographic region, obesity (OR=1.60, 95% CI: 1.08-2.35) and physical activity (monthly frequency of activity longer than 15 minutes, OR=0.97, 95% CI: 0.95-0.99). Conclusion: Nearly 1 of every 5 youth in Canada are at risk for type 2 diabetes, based on early elevated A1C. Elevated A1C in youth is associated with social determinants of health and some lifestyle factors and both should be addressed in prevention efforts.
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