Diabetes and pre-diabetes have skyrocketed among the nation's young people, jumping from 9% of the adolescent population in 2000 to 23% in 2008, a study reports today.
The findings, reported in the journal Pediatrics, are "very concerning," says lead author Ashleigh May, an epidemiologist with the Centers for Disease Control and Prevention.
"To get ahead of this problem, we have to be incredibly aggressive and look at children and adolescents and say you have to make time for physical activity," says pediatric endocrinologist Larry Deeb, former president of medicine and science for the American Diabetes Association.
Of the two types of diabetes, type 2 accounts for more than 90% of cases. In people with diabetes, the body does not make enough of the hormone insulin or doesn't use it properly.
Insulin helps glucose (sugar) get into cells, where it is used for energy. If there's an insulin problem, sugar builds up in the blood, damaging nerves and blood vessels. Long-term complications of diabetes can include heart attacks, blindness, kidney failure, nerve damage and amputations.
May and colleagues examined health data on about 3,400 adolescents ages 12 to 19 from 1999 through 2008. They participated in the CDC's National Health and Nutrition Examination Survey, considered the gold standard for evaluating health in the USA because it includes a detailed physical examination, taking participants' blood pressure and getting fasting blood sugar levels. Their weight and height also are measured.
May notes that the diabetes findings should be interpreted with caution because the fasting blood glucose test was used and there are disadvantages associated with the test. Instead, many physicians use the A1C test, which looks at a person's average blood sugar levels for the past three months.
"I wouldn't be surprised if pre-diabetes and diabetes went up some, but how much it may have gone up is still an open question because of the way they measured it," says Stephen Daniels, chairman of the department of pediatrics at the University of Colorado School of Medicine and a spokesman for the American Heart Association.
Still, about a third of adolescents are overweight or obese, which increases their risk of high blood pressure, type 2 diabetes and other health problems.
Deeb says other research suggests there will be "a 64% increase in diabetes in the next decade," which is even higher than the predicted increase in obesity, "because stress on the pancreas and insulin resistance catches up with people. We are truly in deep trouble. Diabetes threatens to destroy the health care system."
The Pediatrics report also found that overall, half of overweight teens and almost two-thirds of obese adolescents have one or more risk factors for heart disease, such as diabetes, high blood pressure or high levels of bad cholesterol. By comparison, about one-third of normal-weight adolescents have at least one risk factor.
When these risk factors are present in young people, the problems may persist into adulthood, May says.
Says Daniels, "The fact that we have kids who already have risk factors is disconcerting because their risk of cardiovascular disease is already starting to increase."