629 - Prevalence and Demographic Characteristics of Youth with Prediabetes at a Large Pediatric Referral Center from Central Pennsylvania: A 10-year Retrospective Study

Poster Number: 629
Publication Number: 629.3161

Background: Development of pre-diabetes (pre-D) during childhood places youth at an increased risk of developing type 2 diabetes (T2D). Unfortunately, many youths at the time of T2D diagnosis already have serious comorbidities such as cardiovascular disease, renal dysfunction, and neuropathy. Recent data from NHANES reported that 1 in 5 adolescents (ages 12-18 years old) had pre-D. The prevalence of pre-D in adolescents has increased remarkably from 11.6% (1999-2002) to 28.2% (2015-2018). Further exploration of the underlying factors related to the rising rates of pre-D in youth is needed.

Objective: 1) To determine the prevalence of pre-D in youth ages 6-17 years old evaluated at a larger pediatric referral center from Central Pennsylvania, and 2) To identify and describe clinical, nutritional and demographic characteristics of youth diagnosed with pre-D during the study period.

Design/Methods: A 10-year retrospective chart review (01/2010-01/2020) of electronic medical records (EMRs) was completed to identify youth aged 6-17 years old with pre-D at a larger pediatric referral center in the Central Pennsylvania region. ICD10 codes used for chart identification were R73.01, R73.02, R73.03 and R73.09. Pre-D diagnosis was stratified per three subtypes: a) Impaired Fasting Glucose (IFG), b) Impaired glucose tolerance (IGT), and c) Elevated hemoglobin A1c (HA1C) and/or combinations. Patients who did not meet diagnostic criteria for pre-D per American Diabetes Association were excluded. Demographic data including age, sex, and self-reported race/ethnicity was collected. Nutrition status (BMI percentile) was also analyzed. SAS, frequencies were calculated. Fisher’s exact tests were applied to compare the frequencies of the aforementioned groups with respect to IFG, IGT, and HA1C.

Results: We identified 2700 charts with ICD10 codes. Only 552 of these charts fulfilled study inclusion criteria. The prevalence of pre-D in youth ages 6-17 years old was 0.26% during the study period. Mean age at diagnosis was 12.6 ± 2.8 years old, while 50.5% were female. Most youth were White (40.6%) and Black (23%). Only 23.2% reported to be Hispanic. The most common pre-D subtype was elevated HA1C (87.3%) and mean HA1C =5.85 ± 0.24%. Mean BMI (kg/m2)=33.8 ± 8.6, and BMI had a positive correlation with age (p < 0.0001). Unfortunately, 92.3% of these youth had obesity or overweight.

Conclusion(s): The prevalence of youth with pre-D at our health system was lower than recent reported NHANES data. The most frequent pre-D subtype was HA1C. The majority of these youth had overweight or obesity, and their BMI correlated positively with age.