There are around 29.1 million people with diabetes in the United States, and 1 in 4 of these are unaware they have diabetes. A study published in JAMA has focused specifically on diabetes among U.S. teens and finds the prevalence of the disease higher than previously reported.

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Many adolescents may be unaware that they have diabetes.

According to the American Diabetes Association, there are an estimated 208,000 Americans under the age of 20 with type 1 or type 2 diabetes, which represents 0.25 percent of all people in this age group.

The annual incidence of diabetes diagnosed in young people between 2008-2009 was an estimated 18,436 with type 1 diabetes, and 5,089 with type 2 diabetes.

Andy Menke, Ph.D., of Social and Scientific Systems, Silver Spring, MD, and colleagues acknowledged in their study that there are currently few data available on the prevalence of diabetes among adolescents in the U.S.

The team’s objective was to estimate the prevalence of diabetes, the percentage of those who were unaware of their diabetes, and the prediabetes prevalence among adolescents.

Diabetes is a disease marked by high levels of blood glucose. People with diabetes may develop serious complications such as heart disease, stroke, kidney failure, blindness, and premature death if the disease remains undiagnosed. Good blood sugar management can help lower the risk of complications.

The researchers used nationally representative data – the 2005-2014 National Health and Nutrition Examination Survey (NHANES) – which includes glucose data from adolescents between 12-19 years. Teens within the group were randomly selected for an examination the morning after fasting.

There were a total of 2,606 teenagers included in the study; 62 were already diagnosed with diabetes, 20 undiagnosed, and 512 had prediabetes. A person with prediabetes has blood glucose levels higher than normal, but not high enough for a diagnosis of diabetes.

The outcome of the study indicated that the weighted prevalence of diabetes was 0.8 percent, 29 percent of which was undiagnosed.

The prevalence of prediabetes was 18 percent and found to be more common in males than females.

Non-Hispanic black and Hispanic participants had a higher percentage of undiagnosed diabetes and higher prediabetes prevalence in teens than non-Hispanic white participants. The prevalence of diabetes and prediabetes did not change over time.

“The estimates are higher than previously reported; one study found diagnosed diabetes in 0.34 percent of participants aged 10 to 19 years,” the authors write.

“A relatively large proportion was unaware of the condition, particularly among non-Hispanic black participants and Hispanic participants, indicating a need for improved diabetes screening among adolescents.”

The authors say that these are the first estimates of diabetes in a nationally representative sample of U.S. teens that use all three American Diabetes Association recommended biomarkers, which include hemoglobin A1c, FPG, and 2HPG:

These findings may have important public health implications because diabetes in youth is associated with early onset of risk factors and complications.”

The authors conclude by saying that they could not distinguish the type of diabetes from the data. However, previous research in adolescents found that 87 percent had type 1 diabetes.

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