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Adverse social determinants of health (SDOH) are associated with higher prevalence of prediabetes among adolescents, according to a study published online June 11 in JAMA Network Open.
Caleb Harrison, from the UPMC Children’s Hospital of Pittsburgh, and colleagues examined the prevalence of prediabetes by presence or absence of adverse SDOH in adolescents eligible for type 2 diabetes screening based on weight status in a cross-sectional study. Participants were youths aged 12 to 18 years with body mass index (BMI) at or above the 85th percentile who did not have known diabetes.
Data were included for 1,563 individuals, representing 10,178,400 U.S. youths aged 12 to 18 years. The researchers observed independent associations for food insecurity, public insurance, and low income (4.1, 5.3, and 5.7 percent, respectively) with higher prevalence of prediabetes after adjustment for race, ethnicity, and BMI z score. The prevalence of prediabetes was higher overall for Asian, Black, and Hispanic youths, but among White youths, an increasing number of adverse SDOH was associated with higher prevalence of prediabetes (8.3 percent for three versus 0.6 percent for zero adverse SDOH).
“Prediabetes prevalence remained high even in the setting of favorable SDOH among Asian, Black, and Hispanic youth,” the authors write. “Other social and structural determinants of health, such as racism and ethnic discrimination, should be evaluated to determine whether the remaining disparities in prediabetes prevalence can be further explained to develop targeted approaches to type 2 diabetes risk reduction.”
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