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A person with prediabetes has higher than normal blood sugar levels. The levels aren't yet high enough to be considered type 2 diabetes. But often, people who have prediabetes go on to develop type 2 diabetes.
"Prediabetes is very prevalent among adolescents and young adults. We want people to know that this is a serious health condition that raises the risk of developing type 2 diabetes, heart disease and stroke," said study author Linda Andes, a statistician with the CDC's Division of Diabetes Translation.
The good news? "Prediabetes can be reversed," she said. "This can be a wake-up call to motivate people into action -- eating a healthier diet, getting more physical activity and losing weight."
The researchers used data from nationally representative nutrition surveys that included almost 6,000 teens and young adults. Blood sugar levels were assessed with three different testing methods. Other tests, such as blood pressure and cholesterol, were also done.
The study found that 18% of teens had prediabetes. For young adults, that number was 24%.
Obese teens and young adults were more likely to have prediabetes. Male teens and young adults were far more likely to have prediabetes than females.
Several experts not involved with the study discussed the implications.
"The most significant issue I see is that even if a person does not go on to develop diabetes, prediabetes itself is associated with increased cardiometabolic risks in many people," said Dr. Mary Pat Gallagher, director of the pediatric diabetes center at NYU Langone's Hassenfeld Children's Hospital in New York City.
"This means that this group of people should undergo more careful screening and receive more intensive counseling about changes in lifestyle that could improve their health," she said.
But Gallagher noted there isn't the same research in younger people with prediabetes as there is for older people. "We know that lifestyle changes can help adults, and while we hope that this is the case for adolescents, we don't have that data yet."
Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City, said that years ago, type 2 diabetes was very rare in people under 65, and that gradually shifted down until it was rare under age 40.
"Now, we see this high incidence of prediabetes in a younger population," he noted. "When young people have type 2 diabetes, it's a more aggressive type of diabetes that doesn't respond as well to lifestyle changes as when diabetes is in the elderly.
"This really is a wake-up call. This younger generation may need their parents to take care of them, instead of them taking care of their parents," Zonszein said.
Audrey Koltun, a certified diabetes educator at Cohen's Children's Medical Center in New Hyde Park, N.Y., expressed the same concerns about these young patients.
"I am concerned that their parents will be taking care of them due to illnesses, and possibly parents outliving their own children," she said.
She said many of her child patients "practically live in their beds and use their devices or play video games for excessive hours at a time. The days of going outside to play are rare."
Koltun acknowledged that lifestyle changes can be difficult to make, and said real change will require full family support -- from parents, grandparents and even babysitters.
Gallagher said that while more research needs to be done, it's likely that healthy lifestyle choices will benefit young people with prediabetes. She recommended eating a balanced diet that is lower in simple sugars and animal fats. Simple sugars are found in processed foods such as white bread and pasta, cereals, cookies, crackers, sweets and sugar-sweetened beverages.
She also recommended a goal of 60 minutes of moderate physical activity each day.
The study was published Dec. 2 in JAMA Pediatrics.
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