Prediabetes In Adolescents Research Articles

Trends and risk factors of diabetes and prediabetes in US adolescents, 1999–2020

AimsTo assess the national trends in prevalence of diabetes and prediabetes and their major risk factors among adolescents in the US. MethodsWe analyzed data on 6,936 adolescents aged 12 to 19 years from the National Health and Nutrition Examination Surveys (NHANES) between 1999 and 2020. Diabetes was defined by self-reported physician-diagnosis (diagnosed) and by fasting plasma glucose and HbA1c levels (undiagnosed). Prediabetes was identified by fasting plasma glucose and HbA1c levels. Logistic regression was performed to estimate the associations of major risk factors with diabetes and prediabetes. ResultsThe prevalence of prediabetes in adolescents increased from 11.5% in 1999–2002 to 36.3% in 2015–2020. The prevalence of diabetes increased from 0.82% (0.62% of diagnosed and 0.20% of undiagnosed) in 1999–2002 to 1.14% (0.76% of diagnosed and 0.38% of undiagnosed) in 2015–2020, but the increase was not statistically significant (P value = 0.69). Obesity was significantly associated with higher odds of diabetes and prediabetes while boys and Mexican Americans had a significantly higher risk of prediabetes than their counterparts. ConclusionsThe prevalence of prediabetes among adolescents in the US has more than tripled from 1999 to 2020. Obese adolescents are at the greatest risk for diabetes and prediabetes.

Insulin resistance and its role in the pathogenesis of pre-diabetes development in obese adolescents

Background. The prevalence of childhood obesity has increased significantly over the past three decades worldwide, and in this regard, the frequency of diseases associated with obesity, including disorders of carbohydrate metabolism, has increased. The involvement of insulin resistance and insulin deficiency in the development of prediabetes in obesity has been established. However, the significance of each pathological mechanism in the development of prediabetes in childhood and adolescence has not been established. In this regard, in children's practice, there is no reliable data on methods of prevention and treatment of prediabetes in obesity.
 Aim. To study the role of insulin resistance in the development of prediabetes in obese adolescents.
 Materials and methods. The study involved 95 adolescents with obesity. Inclusion criteria: SDS BMI≥2.0, Tanner stage ≥II, age 18.0 years, exclusion criteria: diabetes mellitus. The sample was divided into prediabetics (n=40, mean age 14.0±1.53 years; SDS BMI 3.09±0.54, boys n=23) and non-prediabetics (n=55, mean age 14.6±1.67 years; SDS BMI 3.11±0.54; boys n=32). Both groups were matched on age, SDS BMI, sex (p=0.082, p=0.975, p=0.947, respectively). The research consisted of estimates of BMI, insulin, C-peptide, fasting venous blood glucose, HbA1c, cholesterol, low-density lipoprotein, high Density Lipoprotein, triglycerides, alanine aminotransferase, aspartat aminotransferase, HOMA-IR and TyG indices, results of oral glucose tolerance test at 0 and 2 hours after glucose load, ultrasound of the hepatobiliary system. Prediabetes in adolescents was diagnosed using American Diabetes Association criteria. Data was analyzed by using SPSS Statistics for Windows, Version 26.0.
 Results. Prediabetes was diagnosed in 42.1% (40/95) of cases. There were statistically significant differences between the indices of groups with prediabetes and normal glucose metabolism: fasting plasma glucose – FPG (mean 5.63±0.49; 95% confidence interval – CI 5.48–5.79 vs 5.03±0.42; 4.92–5.15 mmol/L; p0.001); 2hPG (mean 7.04±0.93; 95% CI 6.74–7.34 vs 6.23±0.82; 6.01–6.46 mmol/l; p0.001); HbA1c (mean 5.5±0.31; 95% CI 5.39–5.59% vs 5.2±0.25; 5.15–5.29%; p0.001); cholesterol (4.47±0.73; 95% CI 4.23–4.72 vs 3.96±0.92; 3.73–4.24 mmol/l; p=0.004), low-density lipoprotein (2.89±0.96, 95% CI 2.55–3.20 vs 2.46±0.89, 2.21–2.71 mmol/l; p=0.036). There were no significant differences in fasting insulin, C-peptide, triglycerides, high density lipoprotein, aspartat aminotransferase, alanine aminotransferase, HOMA-IR index and TyG, were also no significant differences in the frequency of hepatic steatosis (47.5% vs 52.7%; p=0.532).
 Conclusion. Teenagers with obesity, with prediabetes, and without disorders of carbohydrate metabolism had a similar level of peripheral tissue sensitivity to the action of insulin. There are additional factors leading to the formation of prediabetes with obesity in the child population that have to be learned in future researches.

Prediabetes is associated with a higher serum neurofilament light chain level in adolescents.

Serum neurofilament light chain (sNfL) level, which is a biomarker indicative of neuroaxonal damage and cognitive impairment, has been reported in several neurological diseases. There has been a lack of studies on the association between sNfL levels and prediabetes in adolescents. This study investigated whether sNfL levels were higher in adolescents with prediabetes undergoing elective orthopedic surgery. The sNfL level was measured in 149 adolescents aged from 12 to 18 years who underwent elective orthopedic surgery at the Hunan Children's Hospital (18 with and 131 without prediabetes). We evaluated the association between prediabetes and sNfL level after adjusting for age, sex, and triglycerides using a multivariable linear regression model. The prevalence of prediabetes in adolescents was 12.08%. Univariate logistic regression analysis showed that prediabetes was related to sNfL. In multivariate logistic regression analysis, the association between prediabetes with sNfL levels remained significant after adjustment for age, sex, and triglyceride. The relationship between the two was further visualized by a smoothed curve. Prediabetes is associated with a higher sNfL. Further large-scale and prospective studies are needed to verify the clinical application of sNfL as a monitoring biomarker for adolescent prediabetes in adolescents and to evaluate the performance of sNfL in predicting the incidence of neuropathy and cognitive dysfunction in adolescents with prediabetes.

Association between skipping breakfast and prediabetes among adolescence in Japan: Results from A-CHILD study.

Adolescents with prediabetes are at high risk of developing type 2 diabetes in later life. It is necessary to identify risk factors for prediabetes in adolescents. This study aimed to examine the association between skipping breakfast and prediabetes among adolescents in Japan. We used the population-based cross-sectional data of eighth grade in junior high school students from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study conducted in Adachi City, Tokyo, Japan, in 2016, 2018, and 2020. Skipping breakfast was assessed using self-reported questionnaires (N=1510). Prediabetes was defined as hemoglobin A1c (HbA1c) levels of 5.6-6.4%. The association between skipping breakfast and prediabetes was evaluated using multivariate logistic regression analysis. Stratified analysis was also performed using BMI, 1 SD or more, or less than 1SD, as overweight was defined as 1SD or more. Students who skipped breakfast were 16.4% (n=248). The prevalence of prediabetes was 3.8% (n=58). Skipping breakfast exhibited a significant association with prediabetes (OR:1.95, 95% CI: 1.03 to 3.69) after adjusting for sex, annual household income, family history of diabetes mellitus, BMI, and survey year. Stratified analysis showed stronger association among students with overweight (BMI ≥1SD) (OR=4.31, 95% CI 1.06-17.58), while non-sigificant among students without overweight (BMI<1SD) (OR=1.62, 95% CI 0.76-3.47). Skipping breakfast in Japanese adolescents, especially those with overweight, was associated with prediabetes. The promotion of avoiding skipping breakfast may help to prevent prediabetes.

The Risk Factors of Prediabetes in Adolescents: A Systematic Review

Background: Pre-diabetes is a risk state for the future development of type 2 diabetes. The risk factors for prediabetes have been categorized as modifiable and non-modifiable. However, conclusive evidence regarding the risk factors associated with pre-diabetes in adolescence is still lacking. This study aims to answer the question of: which risk factors are most associated with the incidence of prediabetes in adolescents? Methods: This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A systematic search was conducted in PubMed, ScienceDirect, Scopus and Web of Science electronic databases using the keywords of “modifiable risk factors”, “non-modifiable risk factors”, “pre-diabetes” and “adolescent” in the time frame of 2010 to 2021. Eligibility criteria were determined based on the (population, intervention, comparison and outcomes) PICOS guidelines. Reference list from identified studies was used to augment the search strategy. Two authors assessed the quality and risk of bias of the studies using National Institute of Health (NIH) Quality assessment tool. Qualitative analysis method was used to review the articles. Based on this, components such as purpose, methodology, risk factors, measurement method and main findings were extracted. Results: As a result of the initial search, 3982 studies were obtained. All duplicates, case reports, reviews and non-English studies were excluded. A total of ten articles that met the pre-defined eligibility criteria were included in this review. The quality of included studies was mostly in the good category. Overall, the association between risk factors and adolescents’ prediabetes appeared to be strongest among modifiable factors such as physical activity, poor diet, smoking, and cardiometabolic factors. The most significant modifiable factor was body mass index (BMI) and the most significant non-modifiable factor was gender. Conclusion: Considering the prominent role of modifiable risk factors in the occurrence of prediabetes in adolescents, it seems necessary to include lifestyle modification programs for this age group. It is also important to pay attention to gender as a non-modifiable factor in the development of prediabetes in adolescents.

Prevalence and Predictors of Prediabetes in Adolescents and Young Adults with Turner Syndrome: A Cross-Sectional Study from Eastern India.

Individuals with Turner syndrome (TS) have a high risk for prediabetes/type 2 Diabetes Mellitus (T2DM). There is scarce data regarding risk factors for prediabetes in TS, specially from South Asia. We conducted a cross-sectional study on girls with TS aged 12-30 years who had achieved pubertal stage B3 and above-spontaneously or with oestrogen. Anthropometric measurements and biochemical tests were conducted, and medical records were reviewed for details about pubertal onset and progression, growth hormone (GH) and oestrogen therapy. Out of 129 patients with TS in our database, 99 met the criteria for inclusion, mean age 18.33+/-3.78 years and mean BMI 20.57+/- 3.71 kg/m2. Prevalence of prediabetes was 23.23%. Plasma-glucose measured after 75 g-oral-anhydrous-glucose-load (OGTT-PPG) identified five additional prediabetes cases, who had normal fasting plasma glucose (FPG) or HbA1c%. Compared to those without prediabetes, TS with prediabetes (n = 23) had higher mean body weight, BMI, waist circumference (WC) [42.02+/- 5.83 vs 36.22+/-8.07, 22.77+/-2.78 vs 19.91+/- 3.72, 85.26+/- 3.52 vs 81.08+/- 4.59, pall < 0.03 ], higher median WC-to-height ratio (WHtR) and WC-to-hip ratio (WHR)((0.64 [0.6-0.69] vs 0.59[0.56- 0.66], 0.9[0.84-1.12] vs 0.85[0.75-1.01], pboth < 0.02), and higher LDL-cholesterol, triglycerides, and greater prevalence of hepatosteatosis (47.1% vs 21.1%, P < 0.01). Among GH recipients (n = 36), those with prediabetes had delayed initiation and shorter duration of GH therapy. There were no differences in cardiometabolic parameters or the prevalence of diabetes between different karyotypic variants of TS. BMI, WC and WHR had significant positive correlation with FBG, OGTT-PPG and HbA1c% (pall < 0.004). Delay in oestrogen initiation had a significant correlation with OGTT-PPG (Spearman's-rho = 0.69, P < 0.004). BMI, WHR and pubertal status were independent predictors for prediabetes (OR: 1.27 [1.03-1.57]), 1.18 [1.04-1.34]) and 0.09[0.02-0.38], respectively, pall < 0.02), but karyotype was not. BMI had the highest sensitivity [cut-off: 21.04 kg/m2 (sensitivity: 82.6%, specificity: 62.2%) and WHR had the highest specificity [cut-off: 0.89 (sensitivity: 73.9%, specificity 78.4%)] for predicting prediabetes. Indian girls with TS have a high risk for prediabetes, irrespective of underlying karyotype and should be screened with oral glucose challenge to identify prediabetes. Timely intervention against central obesity and early initiation of GH and oestrogen should be ensured in TS. Late presenting girls should be closely monitored for dysglycaemia before and during treatment with GH and/or oestrogen.

Undiagnosed prediabetes in Mexican adolescents under poverty in contexts affected by collective violence: A clinical comparison among health services users and hidden population.

The epidemiological pattern of prediabetes in adolescents is understudied. In Mexico, adolescents are exposed to social adversity conditions, including poverty and violence. Therefore, understanding their clinical profiles and how the social determinants of health impose barriers to access to health services is important to address detection, in those who, by their vulnerability, remain a hidden population. This study aimed to describe undiagnosed prediabetes in Mexican adolescents under poverty in violent contexts and to compare the clinical features among health services users and hidden population. This cross-sectional study included 371 adolescents from difficult access locations in violent contexts. Poverty, lack of health services access, and perceived vulnerability were determined in all samples. Endocrine markers (BMI, HOMA-IR, HbA1c, and cortisol) were measured in those with high violence perception. A total of 61.7% of the adolescents had a suburban grid and urban cluster residence, and 77.7-85.7% of them belonged to locations where 35-50% of their population lived below the poverty line. In total, 40-75% had a lack of 10-20% access to health services, and 18.8% had a high perceived vulnerability due to collective violence and were screened. Overall, 61.9% of respondents were newly diagnosed with prediabetes and showed the worst HbA1c (p = 0.001) compared to the health services subsample, which showed the highest BMI (p = 0.031) and insulin resistance (p = 0.025). There is a prediabetes hidden population living in violent contexts under poverty. These social determinants promote poor outcomes in perceived vulnerability and endocrine response and represent barriers to access to health services.

The role of hyperinsulinaemia in screening for prediabetes in the adolescent population: A systematic literature review

Background/aimsPresent screening methods for Type 2 diabetes (T2DM) fall short of detecting prediabetes. This paper summarises the literature on the utility of insulin measurements (hyperinsulinemia) in detecting prediabetes in adolescents. MethodsA systematic literature review was conducted using EMBASE and Medline. Relevant data on hyperinsulinemia in the adolescent population is narrated. ResultsThe database search identified 174 potential articles; 106 underwent a full-paper review, and 36 were included. ConclusionElevated fasting insulin is a marker of impaired insulin resistance and pending beta-cell dysfunction in at-risk adolescents and can be an early indicator of prediabetes.

Prediabetes in adolescents - an emerging epidemic - a cross-sectional survey of medical students at a public university, Quetta, Pakistan.

To determine the prevalence and determinants of prediabetes among adolescents. The cross-sectional study was conducted at a public-sector medical university in Quetta, Pakistan, from December 2019 to February 2020, and comprised students aged 16-19 years. A self-administered questionnaire was used to gather socio-demographic data. Fasting blood sample was taken to measure the fasting plasma glucose level, lipid profile and glycated haemoglobin levels. Height, weight, neck circumference and waist circumference were also measured. Data was analysed using SPSS 21. Of the 351 subjects, 158(45%) were males and 193(55%) were females. The overall mean age was 18.81±0.41 years. Of the total, 81(23.1%) participants were found to have prediabetes. Neck circumference was identified as the strongest predictor for prediabetes, followed by high level of triglycerides, high systolic blood pressure, low levels of high-density lipoproteins, high levels of low-density lipoproteins, high diastolic blood pressure, waist circumference and body mass index (p<0.05). There was no significant difference in the prevalence of prediabetes among male and female students (p>0.05). There was no significant difference in the prevalence of prediabetes among male and female medical students. Neck circumference, Waist circumference, Body mass index, systolic blood pressure, Diastolic blood pressure, Triglyceride and High density Lipoprotein were strong predictors of prediabetes in adolescent population.

Urinary organophosphate esters metabolites, glucose homeostasis and prediabetes in adolescents

BackgroundEmerging experimental evidence indicates that organophosphate esters (OPEs) can trigger glucose metabolic disorders. However, human evidence, especially in adolescents, is unavailable. ObjectivesWe utilized data from the National Health and Nutrition Examination Survey 2011–2014 to evaluate whether urinary OPEs metabolites were associated with prediabetes and glucose homeostasis. MethodsA total of 349 adolescents (12-19-year old) who provided at least 8 h fasting blood samples, had urinary OPEs metabolites detected were included. Prediabetes was defined according to the levels of fasting plasma glucose (FPG), 2-h post oral plasma glucose (2 h-OGTT) and glycated hemoglobin A1c (HbA1c). The homeostatic model assessment (HOMA-IR) and the Single Point Insulin Sensitivity Estimator (SPISE) were used to assess insulin resistance and sensitivity, respectively. Multiple binary logistic and linear regressions were used to evaluate the associations with prediabetes and indices of glucose homeostasis. The least absolute shrinkage and selection operator (LASSO) regression was used to assess the associations in a multi-pollutant context. ResultsAfter adjusting for covariates, certain urinary OPEs metabolites were associated with prediabetes and indices of glucose homeostasis in all adolescents. Stratified analyses by sex revealed that such associations were largely sex-dependent. In females, the multiple pollutant models showed that bis(1,3–32 dichloro-2-propyl) phosphate (BDCIPP) was positively associated with prediabetes [odds ratio (OR) = 2.51, 95%CI:1.29, 4.89, for one scaled unit increase in exposure] and 2 h-OGTT (β = 0.07, 95%CI:0.01,0.12); bis(2-chloroethyl) phosphate (BCEP) was negatively associated with fasting insulin (β = −0.10, 95%CI: 0.19,-0.01) and HOMA-IR (β = −0.10, 95%CI: 0.19,-0.003); and detectable bis(1-choloro-2-propyl) phosphate (BCIPP) (>LOD vs < LOD) was inversely associated with 2 h-OGTT (β = −0.11, 95%CI: 0.21,-0.02). In males, consistent inverse associations were found for detectable di-n-butyl phosphate (DNBP) with prediabetes, FPG, 2 h-OGTT, fasting insulin and HOMA-IR. ConclusionUrinary OPEs metabolites were associated with prediabetes and indices of glucose homeostasis in adolescents. But such associations varied by sex. Future studies with multiple measurements of OPEs exposure are needed to confirm our findings.

The Relationship Between Beverage Consumption and Prediabetes in Predominantly Low-Income Hispanic Children (P11-110-19)

ObjectivesPrevious studies have established a strong positive relationship between soda consumption and prediabetes in adolescents and adults; however, the same relationship in children younger than 10 years has not yet been examined. Furthermore, the associations of 100% fruit juice and artificially sweetened beverage (ASB) consumption with prediabetes remain elusive. The objective of this study was to examine the relationship between prediabetes and beverage consumption (sodas, ASBs, and 100% fruit juice) in predominantly low-income Hispanic 3rd-5th graders. MethodsThis study used baseline data from 793 3rd-5th grade students who participated in TX Sprouts, a cluster randomized nutrition, gardening, and cooking intervention at 16 elementary schools in and around Austin, TX. The following measures were collected at baseline: frequency of soda, ASB, and 100% fruit juice consumption via validated dietary screener, fasting plasma glucose via fasting blood draw, age and sex via questionnaire, height via stadiometer, and weight via TANITA scale. Glucose values of 100–125 mg/dL were categorized as prediabetic based on American Diabetes Association 2018 guidelines. Logistic regression models were run to assess the relationship between beverage consumption and prediabetes, controlling for age, sex, and BMI. ResultsParticipants were 52.4% female and 66.4% Hispanic, with an average age of 9.2 years. The average fasting plasma glucose was 93.3 mg/dL, with 28.5% of students classified as prediabetic. Participants reporting consumption of two or more sodas per day (n = 98) had a 65% higher odds of having prediabetes compared to those reporting no soda consumption on any given day (n = 431) (OR = 1.65; 95% CI 1.04-2.61; P = 0.035). No significant differences were found in consumption of 100% fruit juice or ASBs with prediabetes status. ConclusionsThis is the first study to show a positive relationship between soda consumption and prediabetes in children younger than 10 years, replicating findings in adolescent and adult populations. This study did not find a relationship between ASB and 100% fruit juice consumption and prediabetes. These results suggest that interventions should focus on reducing primarily soda consumption to potentially reduce prediabetes in pediatric populations. Funding SourcesThis study was supported by funding from the National Institutes of Health, National Heart, Lung, and Blood Institute (NHLBI).

Study on the relationship between screen time and prediabetes in adolescents

Objective To explore the relationship between screen time and prediabetes in adolescents. Methods A cross-section study. A total of 532 adolescents aged 12~18 years in Shandong Zibo Vocational Institute were selected by stratified sampling method. The screen time was investigated by questionnaire survey. Measuring fasting fingertip blood glucose, screening for who with potentially abnormal blood glucose, and measuring their fasting venous blood glucose, which is to determine whether it is prediabetes. Results With the increase of screen time, the risk of prediabetes increased continuously. Compared with adolescents with those who spend 0~119 minute per day screen time, the risk of prediabetes of adolescents with an average daily screen time of 120~239, 240~317, ≥318 minute increased by 0.37%, 2.63%, and 3.57%, respectively. After multi-factor adjustment, the risk of prediabetes with who take 240~317, ≥318 minute per day screen time is still higher than who with the average daily screen time of 0~119 minute, the adjusted OR was 2.502 (95% CI 1.279-4.897), 2.337(95% CI=1.189-4.594). Conclusion The results of this study show that the longer the screen time, the higher the risk of prediabetes in adolescents, and adolescents should be encouraged to reduce screen time. Key words: Adolescent; Prediabetic state; Screen time

Anthropometric indicators as predictor of pre-diabetes in Indian adolescents

IntroductionIn India, there are approximately 41 million diabetics to date. Impaired glucose tolerance or pre-diabetes may occur as early as adolescence. ObjectiveTo find out the cut-off values of body mass index (BMI) and waist circumference to predict pre-diabetes in adolescents in north India. MethodsA cross-sectional study was conducted among 526 students aged 17–19 years, in the Institute of Paramedical Sciences, Chatrapati Shahuji Maharaj University, Kanpur. A pre-tested questionnaire was used and the diagnostic criteria of the American Diabetic Association were applied. Receiver operating characteristic(ROC) analysis was used to assess the cut-offs of BMI and waist circumference for predicting prediabetes. ResultsROC analysis showed that BMI is a good predictor of prediabetes for both boys and girls.Area under the ROC curve was 0.828 for boys and 0.838 for girls, respectively. The cut-off values of BMI for predicting prediabetes were identified as ≥22.8kg/m2 in boys and ≥20.5kg/m2 in girls. Upon ROC analysis for waist circumference, it was observed that it was a good predictor of prediabetes both for boys (area under the curve 0.804) and girls (area under the curve 0.795). The cut-offs for waist circumference for predicting prediabetes were found to be ≥82.5cm for boys and ≥80.3cm for girls. ConclusionBMI and waist circumference estimation can be done for early detection of prediabetes in adolescents for further diagnostic evaluation and management.

A Systematic Review of Transitional Care for Emerging Adults with Diabetes

The prevalence of diabetes and prediabetes in adolescents is increasing. A systematic review of 31 research articles focusing on transitional care for adolescents or emerging adults with diabetes or prediabetes was completed. Studies focused on those with type 1 diabetes, not type 2 diabetes or prediabetes, and were primarily descriptive. Major findings and conclusions include differences in pediatric versus adult care delivery and the importance of structured transitional programs using established recommendations of leading national organizations. Implications include future research on program development, implementation, and evaluation that is inclusive of adolescents and emerging adults, regardless of diabetes type, or prediabetes.

Adolescent prediabetes in a high-risk Middle East country: a cross-sectional study.

ObjectiveTo estimate the prevalence of prediabetes in adolescents living in a high-risk country and to detect risk factors associated with this disorder.DesignSurvey questionnaire combined with physical measurements and blood sugar determination.SettingDoha, capital city of Qatar.ParticipantsA total of 1694 male and female students aged 11–18 years without previously diagnosed diabetes enrolled in four schools.Main outcome measureBlood sugar measurements. Other measured variables included gender, height, weight, abdominal circumference, country of origin, family history of diabetes and frequency of exercise.ResultsUsing a random blood sugar ≥7.8 mmol/L or a fasting blood sugar ≥5.5 mmol/L as cutpoints, we identified 4.2% of students (56 boys, 15 girls) as probable prediabetics. In a multivariate model, being boys (OR 3.2, 95% CI 1.7–6.2), having a diabetic parent (OR 1.9, 95% CI 1.1–3.2) or having a waist-to-height ratio >0.5 (OR 1.8, 95% CI 1.1–3.0) were significantly associated with being a prediabetic. The parental origin of diabetes had a differential effect upon blood sugar. The mean random blood sugar in students with a maternal inheritance pattern of diabetes was 5.61 mmol/L ± 1.0, compared to 5.39 mmol/L ± 0.89 in students with a paternal inheritance pattern (p = 0.02).ConclusionsIn a country with a high risk of adult diabetes, we identified 4.2% of students aged 11–18 as being prediabetic. Risk factors associated with prediabetes included male gender, family history of diabetes and waist-to-height ratio >0.5.

Abstract P143: Hemoglobin A1C Screening in 31546 Adolescent Blood Donors

Objective: While the global epidemic of diabetes mellitus in adults is well documented, there are few reliable estimates of the prevalence of diabetes and prediabetes in adolescents in the United States. We conducted systematic hemoglobin A1C (HbA1C) screening in a very large adolescent blood donor population. Methods: A screening program was implemented in which HbA1C was measured at the time of blood donation among 31,546 volunteer high-school blood donors, 16-19 years of age, who participated in school blood drives conducted by Carter BloodCare, the largest independent blood program in Texas, between 2011 and 2013. The main study measures were the prevalence of HbA1C in the prediabetes range, 5.7-6.4% (39-46 mmol/mol) and in the diabetes range, ≥ 6.5% (≥ 48 mmol/mol), in the overall cohort as well as stratified by sex, race/ethnicity, and sociodemographic characteristics. Results: In the overall cohort, the prevalence of HbA1C in the prediabetes range was 11.0% (95% CI 10.7, 11.4), and the prevalence of HbA1C in the diabetes range was 0.53% (95% CI, 0.46, 0.62). The prevalence of HbA1C ≥ 5.7% (including prediabetes and diabetes) was higher in boys compared with girls (15.7% vs.7.9%, P&lt;0.001), and was especially high in race/ethnic minorities (32.7%, 19.7%, 13.1%, respectively in Blacks, Asians, Hispanics) compared with 8.0% in Whites (p&lt;0.001 for each vs. Whites). In analyses of cardiovascular risk factors stratified by HbA1C categories, higher total cholesterol and systolic and diastolic blood pressure were observed in donors with HbA1C in the prediabetes and diabetes range (P trend &lt; 0.001 for all, Table ). Conclusions: HbA1C values in the prediabetes or diabetes range are common among adolescent blood donors, particularly among boys and ethnic minorities. Blood donation programs can be used as a valuable portal for public health screening, and may provide the opportunity for targeted public health interventions, triaging of donors to medical care, and research programs for community-based participatory interventions.

Prediabetes: The Effects on Arterial Thickness and Stiffness in Obese Youth

Adults with prediabetes are at increased risk to develop cardiovascular disease. Whether prediabetes in adolescents is associated with early markers of cardiovascular disease is not known. We sought to 1) compare the cardiovascular risk profiles among adolescents and young adults with prediabetes with those with normal glucose tolerance and 2) determine whether prediabetes is independently associated with noninvasive measures of arterial thickness and stiffness. We studied 102 obese youth with prediabetes and 139 obese youth with normal glucose tolerance in a cross-sectional study. Prediabetes or at increased diabetes risk was diagnosed by a fasting blood glucose level of ≥100 to 125 mg/dL, 2-hour oral glucose tolerance test value of ≥140 to 199 mg/dL, or a hemoglobin A1c (HbA1c) value of ≥5.7% to 6.4%. Arterial thickness and stiffness were measured by carotid intima-media thickness (IMT), augmentation index, pulse wave velocity, and brachial distensibility (BrachD). Nearly 50% of youth were diagnosed with prediabetes by HbA1c. Youth with prediabetes had worse metabolic profiles with higher BMI z score, systolic blood pressure, and fasting insulin; increased carotid IMT; and lower BrachD compared with normal glucose-tolerant youth (P < .05). Multivariate regression analysis found prediabetes was a significant determinant of internal carotid IMT and BrachD (P < .05). After excluding youth diagnosed by HbA1c, the prediabetes group was borderline significant for internal carotid IMT (.1 > P ≥ .05) only. Youth with prediabetes have worse cardiometabolic risk factors and evidence of increased arterial thickness and stiffness. Interventions to prevent prediabetes are crucial to reduce the development of early arterial disease.