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National Health and Nutrition Examination Survey, 1999-2002

Glen E. Duncan, PhD, RCEPSM

Arch Pediatr Adolesc Med. 2006;160:523-528.

Objective  To determine the current prevalence of self-reported diabetes and impaired fasting glucose levels among US adolescents.

Design and Setting  Cross-sectional, National Health and Nutrition Examination Survey (1999-2002).

Participants  A sample of 4370 adolescents (aged 12-19 years) with self-reported diabetes and a subsample of 1496 adolescents without self-reported diabetes who had fasted for at least 8 hours. Subjects who reported having diabetes and using insulin were further categorized as having type 1 diabetes, those reporting having diabetes and not using insulin as having type 2 diabetes, and those with a fasting plasma glucose level greater than or equal to 5.6 mmol/L (100 mg/dL) as having impaired fasting glucose levels.

Main Outcome Measures  Prevalence of self-reported diabetes, type 1 and type 2 diabetes, and impaired fasting glucose levels among US adolescents.

Results  In the full sample, 0.5% (95% confidence interval [CI], 0.24%-0.76%) of adolescents reported having diabetes. Of those reporting diabetes, roughly 71% (95% CI, 56%-86%) were categorized as having type 1 and 29% (95% CI, 14%-44%) as having type 2 diabetes. In the subsample, roughly 11% (95% CI, 8%-14%) had impaired fasting glucose levels. Using population-based sample weights, these proportions were equivalent to 39 005 US adolescents with type 2 diabetes and 2 769 736 with impaired fasting glucose levels.

Conclusions  The prevalence of type 2 diabetes and impaired fasting glucose levels is substantial among US adolescents. These estimates have important implications for public health because of the high rate of conversion from impaired fasting glucose level to type 2 diabetes in adults and the increased risk of cardiovascular disease in individuals with type 2 diabetes.

Author Affiliation: Nutritional Sciences Program, Department of Epidemiology, University of Washington, Seattle.

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