Diabetes, Impaired Fasting Glucose, and Elevated HbA1c in U.S. Adolescents: The Third National Health and Nutrition Examination Survey

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Abstract
OBJECTIVE—Using population-based data, we estimated the prevalence of diabetes, impaired fasting glucose, and elevated HbA1c (>6%) levels in U.S. adolescents. RESEARCH DESIGN AND METHODS—The Third National Health and Nutrition Examination Survey (1988–1994) examined a representative sample of the U.S. population, which included 2,867 adolescents aged 12–19 years who had serum glucose measured. RESULTS—A total of 13 adolescents in the sample were considered to have diabetes; 9 reported using insulin, 2 reported using oral agents only, and 2 did not report any treatment but had high glucose levels (≥11.1 mmol/l regardless of length of fast or ≥7.0 mmol/l after an 8-h fast). Four of these cases (31% of the sample with diabetes) were considered to have type 2 diabetes. The estimated prevalence of diabetes (all types) per 100 adolescents ages 12–19 years was 0.41% (95% confidence interval 0–0.86). The prevalence of impaired fasting glucose (≥6.1 mmol/l) among adolescents without diabetes who had fasted for at least 8 h was 1.76% (0.02–3.50). The prevalence of elevated HbA1c (>6%) was 0.39% (0.04–0.74). CONCLUSIONS—National data reflect the presence of type 2 diabetes in U.S. adolescents, but the survey sample size was not large enough to obtain precise prevalence estimates because of the relatively low prevalence.