June 2013 Clinical Laboratory News: Volume 39, Number 6
Prediabetes on the Rise in the U.S.
The last decade has seen a worrisome rise in U.S. cases of prediabetes, a condition associated with a higher risk of developing type 2 diabetes, according to a newly published study. In light of this finding, the authors suggest that diabetes prevention programs target demographic subgroups experiencing the greatest increase in prediabetes prevalence.
Researchers analyzed data from 19,182 nonpregnant individuals age 12 or older who participated in the National Health and Nutrition Examination Surveys during three time periods: 1999–2002, 2003–2006, and 2007–2010. Using hemoglobin A1c levels of 5.7–6.5% (A1C5.7) or fasting plasma glucose 100–126 mg/dL, the team found that age-adjusted prediabetes prevalence increased 21% over the 10 year period, 1999–2010. The results are significant because the study is the first of its kind to use a nationally representative sample to assess changes in prediabetes prevalence during the first decade of the 21st Century.
While prediabetes prevalence rose for all subgroups studied, it increased the most for non-Hispanic blacks and individuals below the federal poverty level, with both groups undergoing increases of more than 11 percentage points (ppts). The proportion of adolescent girls and women with prediabetes also grew by 7.9 ppts, a rate nearly twice that of males. Researchers found this statistic particularly concerning because children exposed to hyperglycemia in the womb have a higher risk of becoming diabetic.
Most surprising of all, the study reveals that individuals with a normal body mass index (BMI) experienced an increase in prediabetes cases greater than any other BMI group, with A1C5.7 prevalence more than doubling for the normal BMI group.
According to the authors, further investigation is needed to identify the factors that might explain this pattern. They also recommend consistent population surveillance to identify, quantify, and characterize the population of high-risk individuals in order to better target diabetes prevention efforts.