Blood spot-based measures of glucose homeostasis and diabetes prevalence in a nationally representative population of young US adults

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 1V 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 HbAlc. Reliability was lower for fasting glucose and lowest for random glucose. Mean (SD) HbAl c was 5.6% (0.8%). More than a quarter (27.4%) had HbAlc-defined prediabetes. HbAlc 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 HbAlc 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., HbAlc < 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. (C)2014 Elsevier Inc. All rights reserved.