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Prediabetes prevalence more than doubled among U.S. youth from 1999 to 2018, national data indicated.

According to National Health and Nutrition Examination Survey (NHANES) data on over 6,500 youth, the prevalence of prediabetes increased from 11.6% in 1999-2002 to 28.2% in 2015-2018, Junxiu Liu, PhD, of Icahn School of Medicine at Mount Sinai in New York City, and colleagues reported in .

However, the research letter identified certain emerging trends across population subgroups when it came the prediabetes prevalence, defined as no recorded diagnosis of diabetes but a hemoglobin A1c level between 5.7% to 6.4% or a fasting plasma glucose level of 100 to 125 mg/dL.

Some of the sharpest spikes in prevalence occurred in youth with obesity. Increases across BMI groups form 1999-2002 to 2015-2018 were:

• Underweight or normal weight: 9.42% to 24.3%
• Overweight: 15.3% to 27.5%
• Obesity: 18.2% to 40.4%

This dramatic spike in prediabetes prevalence was apparent for youth of all ages. Specifically, those ages 12 to 15 saw a rise in prediabetes prevalence from 13.1% in 1999-2002 up to 30.8% by 2015-2018. As for older teens ages 16 to 19, these rates likewise more than doubled from 10% up to 25.6%.

Both sexes sustained big spikes in prediabetes rates: increasing from 7.1% to 19.6% for females and from 15.8% to 36.4% for males.

All races and ethnicities likewise saw rates jump during this time period:

• Hispanic: 13.4% to 28.6%
• Black: 11.7% to 32.3%
• White: 11.5% to 26.8%

The only racial/ethnic group without a spike recorded was Asian youth, because data was too inconsistent prior to the NHANES cycle 2011-2014.

As for changes across levels of food security, youth who had low (12% vs 9.6%), marginal (11.4% vs 45.5%), or full food security (10.8% vs 25.6%) all saw sharp increases in prediabetes rates between 1999-2002 and 2015-2019. However, youth who experienced very low food security saw a slight rise in prediabetes rates, although this wasn't a significant difference over the years (18.4% vs 26.3%).

Similarly, all youth regardless of parental education level saw significant increases in prediabetes rates during this time frame.

This isn't the first data to indicate alarming rises in prediabetes rates. Liu's group referenced another recent study that estimated roughly one in five youth ages 12 to 18 and almost one quarter of those ages 19 to 24 met the criteria for prediabetes in 2016.

"The US Preventive Services Task Force recently released a recommendation on screening for prediabetes and type 2 diabetes among adults, but no recommendation has been issued for youths to date," Liu's group pointed out, emphasizing the need for greater prevention efforts.

Their analysis, which included 10 cycles of NHANES survey data, looked at a total of 6,598 youth (average age 15.5).

Liu's group noted that only the one blood biomarker was used to determine prediabetes status and that oral glucose tolerance tests weren't utilized. Because of this, they said the rates of prediabetes reported in these surveys may actually be underestimated, if anything.

Another limitation was the relatively small sample sizes, especially during the later survey cycles, which may have led to interaction assessments being underpowered.

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