Prevalence of diagnosed and undiagnosed type 2 diabetes mellitus among US adolescents: results from the continuous NHANES, 1999-2010.

Publisher: Oxford University Press Country of Publication: United States NLM ID: 7910653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-6256 (Electronic) Linking ISSN: 00029262 NLM ISO Abbreviation: Am J Epidemiol Subsets: MEDLINE

Publication: Cary, NC : Oxford University Press
Original Publication: Baltimore, School of Hygiene and Public Health of Johns Hopkins Univ.

Diabetes Mellitus, Type 2/*diagnosis ; Diabetes Mellitus, Type 2/*epidemiology; Adolescent ; Adult ; Blood Glucose ; Child ; Cross-Sectional Studies ; Diabetes Mellitus, Type 1/epidemiology ; Diabetes Mellitus, Type 2/ethnology ; Female ; Humans ; Incidence ; Male ; Nutrition Surveys ; Prevalence ; Sex Distribution ; Socioeconomic Factors ; United States/epidemiology

Although prevalence and incidence of type 2 diabetes mellitus (T2DM) are reportedly increasing among adolescents, national data are lacking, particularly in regard to undiagnosed T2DM. To estimate the prevalence of diagnosed and undiagnosed T2DM among US adolescents, we analyzed a nationally representative cross-section of 11,888 adolescents aged 12-19 years who received a diabetes interview in the Continuous National Health and Nutrition Examination Survey during 1999-2010. Among them, a random subsample of 4,661 adolescents also had fasting blood samples collected. Persons who reported a previous diabetes diagnosis and were either taking no medication or taking an oral hypoglycemic agent (with or without insulin) were classified as having T2DM; persons who reported using insulin alone were classified as having type 1 diabetes. Undiagnosed diabetes was defined as a fasting plasma glucose concentration of ≥126 mg/dL and was assumed to be type 2. In the fasting subsample, 31 diabetes cases (types 1 and 2) were identified, representing a prevalence of 0.84% (weighted 95% confidence interval (CI): 0.51, 1.40) (276,638 cases; 95% CI: 134,255, 419,020). Estimates of the prevalences of type 1 and type 2 diabetes were 0.48% (95% CI: 0.23, 1.02) and 0.36% (95% CI: 0.20, 0.67), respectively, indicating that T2DM accounted for 43% of all cases. Further, undiagnosed T2DM prevalence was 0.12% (95% CI: 0.05, 0.31), representing 34% of T2DM cases (40,611 cases; 95% CI: 2,850, 78,373). T2DM accounts for approximately half of adolescent diabetes in the United States, and one-third of these cases are undiagnosed.

Comment in: Am J Epidemiol. 2014 Feb 1;179(3):396-7. (PMID: 24243743)
Comment in: Am J Epidemiol. 2014 Feb 1;179(3):395-6. (PMID: 24243744)
Comment in: Am J Epidemiol. 2014 Feb 1;179(3):397-9. (PMID: 24588008)

Diabetes Care. 2004 May;27(5):1047-53. (PMID: 15111519)
Health Place. 2010 May;16(3):547-56. (PMID: 20129809)
Arch Pediatr Adolesc Med. 2006 May;160(5):523-8. (PMID: 16651496)
Control Clin Trials. 2004 Oct;25(5):458-71. (PMID: 15465616)
Diabetes Care. 2006 Jun;29(6):1263-8. (PMID: 16732006)
J Autism Dev Disord. 2009 Mar;39(3):464-70. (PMID: 18791815)
JAMA. 2012 Feb 1;307(5):483-90. (PMID: 22253364)
Pediatr Clin North Am. 2005 Dec;52(6):1579-609. (PMID: 16301084)
J Pediatr. 2012 Jun;160(6):904-10. (PMID: 22240107)
Adolesc Med State Art Rev. 2010 Apr;21(1):86-102, ix. (PMID: 20568557)
Endocr Res. 2008;33(1-2):35-58. (PMID: 19156573)
Diabetes Care. 2001 May;24(5):834-7. (PMID: 11347739)
QJM. 2009 Nov;102(11):799-806. (PMID: 19734298)
Pediatr Ann. 2007 Feb;36(2):89-95. (PMID: 17330571)
Diabetes Care. 2011 Jul;34(7):1628-33. (PMID: 21636800)
Diabetes Care. 2004 Jan;27(1):17-20. (PMID: 14693960)
Diabetes Care. 2012 Jan;35 Suppl 1:S64-71. (PMID: 22187472)
Endocrinol Metab Clin North Am. 1999 Dec;28(4):765-85. (PMID: 10609119)
Diabetes Care. 2011 Jun;34(6):1306-11. (PMID: 21515842)
Arch Dis Child. 2004 Jun;89(6):502-4. (PMID: 15155389)
JAMA. 2002 Oct 9;288(14):1728-32. (PMID: 12365956)
Pediatrics. 2006 Oct;118(4):1510-8. (PMID: 17015542)
JAMA. 2003 Oct 8;290(14):1884-90. (PMID: 14532317)
J Pediatr Endocrinol Metab. 2000;13 Suppl 6:1395-402. (PMID: 11202215)
Expert Rev Cardiovasc Ther. 2008 Mar;6(3):315-22. (PMID: 18327993)
Adolesc Med State Art Rev. 2010 Apr;21(1):103-19, x. (PMID: 20568558)
Arch Pediatr Adolesc Med. 2005 Jan;159(1):37-44. (PMID: 15630056)
Horm Res. 2005;63(2):75-85. (PMID: 15677872)
N Engl J Med. 2012 Jun 14;366(24):2247-56. (PMID: 22540912)
Diabetes Care. 2007 Nov;30(11):2976-9. (PMID: 17965315)

DK 63608 United States DK NIDDK NIH HHS; R00 DE-018739 United States DE NIDCR NIH HHS; R01 DE013094 United States DE NIDCR NIH HHS; R00 DE018739 United States DE NIDCR NIH HHS; R01 DE-13094 United States DE NIDCR NIH HHS; P30 DK063608 United States DK NIDDK NIH HHS

Keywords: adolescents; diabetes mellitus; etiology; prevalence; undiagnosed diabetes

0 (Blood Glucose)

Date Created: 20130727 Date Completed: 20131126 Latest Revision: 20220408

20221213

PMC3783093

10.1093/aje/kwt088

23887044