Quynh C Nguyen1, Eric A Whitsel2, Joyce W Tabor3, Carmen C Cuthbertson4, Mark H Wener5, Alan J Potter5, Carolyn T Halpern6, Ley A Killeya-Jones3, Jon M Hussey6, Chirayath Suchindran7, Kathleen Mullan Harris8. 1. Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC. Electronic address: quynh.nguyen@health.utah.edu. 2. Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC. 3. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC. 4. Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC. 5. Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA. 6. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, Chapel Hill, NC. 7. Department of Biostatistics, UNC Gillings School of Global Public Health, Chapel Hill, NC. 8. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Abstract
PURPOSE: We investigated understudied biomarker-based diabetes among young US adults, traditionally characterized by low cardiovascular disease risk. METHODS: We examined 15,701 participants aged 24 to 32 years at Wave IV of the National Longitudinal Study of Adolescent Health (Add Health, 2008). The study used innovative and relatively noninvasive methods to collect capillary whole blood via finger prick at in-home examinations in all 50 states. RESULTS: Assays of dried blood spots produced reliable and accurate values of HbA1c. Reliability was lower for fasting glucose and lowest for random glucose. Mean (SD) HbA1c was 5.6% (0.8%). More than a quarter (27.4%) had HbA1c-defined prediabetes. HbA1c was highest in the black, non-Hispanic race/ethnic group, inversely associated with education, and more common among the overweight/obese and physically inactive. The prevalence of diabetes defined by previous diagnosis or use of antidiabetic medication was 2.9%. Further incorporating HbA1c and glucose values, the prevalence increased to 6.8%, and among these participants, 38.9% had a previous diagnosis of diabetes (i.e., aware). Among those aware, 37.6% were treated and 64.0% were controlled (i.e., HbA1c < 7%). CONCLUSIONS: A contemporary cohort of young adults faces a historically high risk of diabetes but there is ample opportunity for early detection and intervention.
PURPOSE: We investigated understudied biomarker-based diabetes among young US adults, traditionally characterized by low cardiovascular disease risk. METHODS: We examined 15,701 participants aged 24 to 32 years at Wave IV of the National Longitudinal Study of Adolescent Health (Add Health, 2008). The study used innovative and relatively noninvasive methods to collect capillary whole blood via finger prick at in-home examinations in all 50 states. RESULTS: Assays of dried blood spots produced reliable and accurate values of HbA1c. Reliability was lower for fasting glucose and lowest for random glucose. Mean (SD) HbA1c was 5.6% (0.8%). More than a quarter (27.4%) had HbA1c-defined prediabetes. HbA1c was highest in the black, non-Hispanic race/ethnic group, inversely associated with education, and more common among the overweight/obese and physically inactive. The prevalence of diabetes defined by previous diagnosis or use of antidiabetic medication was 2.9%. Further incorporating HbA1c and glucose values, the prevalence increased to 6.8%, and among these participants, 38.9% had a previous diagnosis of diabetes (i.e., aware). Among those aware, 37.6% were treated and 64.0% were controlled (i.e., HbA1c < 7%). CONCLUSIONS: A contemporary cohort of young adults faces a historically high risk of diabetes but there is ample opportunity for early detection and intervention.
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