New data published by the Centers for Disease Control and Prevention (CDC) reveals an alarming figure: 1 in 3 adolescents in the United States has prediabetes, a condition that increases the risk of developing type 2 diabetes, cardiovascular diseases, and strokes.
The analysis, based on data collected during 2023, estimates that 8.4 million youth between the ages of 12 and 17—equivalent to 32.7% of this population—are in a state of prediabetes.
The condition, considered by the CDC as a “critical warning,” is defined by having higher-than-normal glucose levels without reaching the official threshold for a type 2 diabetes diagnosis.
“This prediabetes data in adolescents is a wake-up call. Type 2 diabetes poses a significant threat to the health of our nation’s youth,” warned Christopher Holliday, director of the CDC’s Division of Diabetes Translation, in a statement released Tuesday, July 8.
The report draws from the national Health and Nutrition Examination Survey (NHANES), which analyzed diagnostic histories and results of fasting glucose and hemoglobin A1c tests in adolescents. The data spans two periods: from 2017 to March 2020, and from August 2021 to August 2023.
While the methods do not allow for exact comparisons with previous estimates, the CDC emphasizes that the trend is increasing. A methodological adjustment suggests that the percentage of prediabetes in 2015-2016 would have been 28%, whereas earlier studies placed this figure around 20%.
Factors Behind the Increase
The study warns that the rise in cases is linked to the childhood obesity epidemic in the country, though it notes that not all adolescents with prediabetes will develop type 2 diabetes. Among the risk factors identified by the CDC are overweight, a family history of type 2 diabetes, and physical activity fewer than three times per week.
Holliday insists that the situation can be reversed. “It’s not too late to change course. Simple lifestyle changes, such as healthy eating and physical activity, can make a big difference in preventing or delaying type 2 diabetes,” he says.
The report also warns about the upward trend in new diabetes diagnoses in adults. After more than a decade of decline, the numbers began rising again, with 1.5 million cases detected in 2023 alone.
Is Type 2 Diabetes an Inevitable Path?
Experts consulted clarify that the progression from prediabetes to type 2 diabetes is not guaranteed and that there are significant individual differences. Meg Bensignor, a pediatric endocrinologist at the University of Minnesota’s Pediatric Obesity Medicine Center, told STAT that “not all children with confirmed prediabetes through testing will end up developing the disease.”
Still, the higher the body mass index (BMI) or A1c level at diagnosis, the more weight is gained, and the more adverse social factors exist, the greater the risk.
Bensignor highlights the risk to the pancreas and beta cells in childhood: “If you have prediabetes, that already indicates your pancreas and beta cells are under a lot of pressure. Children with type 2 diabetes lose beta cell function much faster than adults.”
From her clinical perspective, she acts preventively: “We treat everyone as if they will develop type 2 diabetes because we don’t know who will, and suffering from this disease during childhood can be devastating due to the multiple comorbidities.”
Nancy Crimmins, a pediatric endocrinologist at Cincinnati Children’s Hospital Medical Center and founder of a prediabetes clinic, points to the uncertainty about who will progress and who will not. “When you look at the numbers of adolescents with prediabetes versus those who ultimately develop type 2 diabetes, the count drops dramatically,” she explains.
She details that previous studies have estimated that around 70% of youth return to normal blood glucose levels after puberty, though some studies show reversal rates ranging from 45% to 75%. “One of the big questions in our field is: Can we identify those children who will progress and those who won’t?”
The CDC recommends weight reduction and increased physical activity as primary preventive strategies, especially for those with risk factors. The medical community stresses the importance of early diagnosis and intervention to prevent the development of chronic diseases in adolescence, which would have a strong impact on the future health of these youth.
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