Diabetes risk in overweight, obese teens varies substantially by baseline HbA1c

Five-year diabetes risk among teens with overweight or obesity varies substantially by baseline HbA1c levels, according to a study published online Jan. 17 in JAMA Network Open.

Francis M. Hoe, M.D., from Kaiser Permanente Roseville Medical Center in California, and colleagues assessed the risk for future type 2 diabetes (T2D) among 74,552 adolescents (aged 10 to 17 years) with overweight and obesity.

The researchers found that the overall T2D incidence was 2.1 per 1,000 person-years, with a five-year cumulative incidence of 1.0%. A higher five-year cumulative T2D incidence was associated with higher baseline HbA1c (<5.5% to 5.5 to 5.6%: 0.3 to 0.5%; 5.7 to 5.8%: 1.1%; 5.9 to 6.0%: 3.8%; 6.1 to 6.2%: 11.0%; and 6.3 to 6.4%: 28.5%). Higher baseline HbA1c was associated with greater T2D risk compared with HbA1c <5.5%. Independent risk factors also included higher body mass index category, older age, female sex, and Asian or Pacific Islander race (hazard ratio, 1.7). Black race or Hispanic ethnicity were not risk factors compared with White race.

"These findings suggest that T2D surveillance in adolescents should be tailored based on HbA1c level, among other risk factors," the authors write.