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Teen Diabetes: Cases Double, Other Heart Risks Still High

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The number of teens in the U.S. with diabetes or prediabetes has skyrocketed in the last decade, jumping from 9 to 23 percent, new data finds.

Other cardiovascular risk factors, including high blood pressure and bad cholesterol, were stable during that period, but remain relatively high.

"This has serious long-term public health implications for this country," said Dr. Vivian Fonseca, president of medicine and science with the American Diabetes Association, who was not involved in the research. "We're likely to see a lot of people get diabetes and have cardiovascular events at a relatively young age over the next 10 to 20 years."

The new data, published online in the journal Pediatrics Monday, includes nearly 3,400 children ages 12 to 19 from the Centers for Disease Control's National Health and Nutrition Examination Survey, designed to track the health and nutrition of Americans.

The percent of overweight and obese teens did not change significantly from 1999 through 2008, hovering around the current estimate of 34 percent. The prevalence of prehypertension and high blood pressure also stayed relatively stable, at around 14 percent, as did high levels of LDL or "bad" cholesterol, at 22 percent. Low levels of HDL or "good" cholesterol stayed at about 6 percent.

However, the prevalence of prediabetes and diabetes jumped significantly, from 9 percent of teens in 1999-2000 to 23 percent in 2007-2008.

"I am reassured that at least we haven't seen a continuing rise in the rate of childhood obesity,” said Dr. Lori Laffel, chief of pediatrics at the Joslin Diabetes Center and a professor at Harvard Medical School.

“I am reassured that most of the cardiovascular risk factors the researchers looked at have not increased," she continued. "But it is concerning that it looks like the rates of prediabetes and diabetes have more than doubled over that 10-year period."

Laffel said that the results should be validated and raise interesting questions about what, if anything, is driving the change in diabetes rates. For example, she said it is somewhat puzzling that obesity rates have stayed relatively stable while diabetes has increased, given the close ties between the two. Obesity increases the risk of impaired glucose tolerance, insulin resistance and the development of type 2 diabetes in both adults and children.

But overall, the new study does reinforce the link between obesity and heart-health risk factors.

About half of the overweight teens and more than 60 percent of the obese participants had at least one cardiovascular risk factor, a finding researchers call "concerning, given growing evidence demonstrating that cardiovascular risk factors present during childhood may persist into adulthood." The most common combination of risk factors among those teens was bad cholesterol and high blood pressure, or prehypertension, both of which can increase the risk of developing heart disease.

"This really speaks to the need for pediatricians to be vigilant about following screening recommendations, especially for obese and overweight teens," said study co-author Ashleigh May with the CDC's division of nutrition, physical activity and obesity, adding that 35 percent of normal-weight teens also had at least one risk factor. "We do see these risk factors are high for all youth, not just overweight and obese youth."

What the study points to, she said, is a pressing need for better prevention given that even moderate changes can have profound results. Studies have suggested that by eating less fat and fewer calories, and getting the equivalent of around 20 minutes of exercise per day, people can reduce their risk of developing diabetes by nearly 60 percent.

"We do know that we can slow or even halt the progression of prediabetes and diabetes," said Fonseca.

But the new findings raise serious red flags about what could happen without improved intervention and prevention.

"This is telling us that there is a very high prevalence of obesity-related problems in people in the age group 12 to 19. That's something we used to see only in people in their 40s," Fonseca said. "What this really means is that people are going to get serious health issues when they're in the prime of their lives."

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