title: Blood spot-based measures of glucose homeostasis and diabetes prevalence in a nationally representative population of young US adults.
abstract: OBJECTIVE
  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 IV 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 HbA1c. Reliability was lower for fasting glucose and lowest for random glucose. Mean (SD) HbA1c was 5.6% (0.8%). More than a quarter (27.4%) had HbA1c-defined prediabetes. HbA1c 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 HbA1c 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., HbA1c < 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.
authors.affiliation: Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC. Electronic address: quynh.nguyen@health.utah.edu.
authors.forename: Quynh C
authors.initials: QC
authors.lastname: Nguyen
authors.affiliation: Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Whitsel
authors.affiliation: Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Joyce W
authors.initials: JW
authors.lastname: Tabor
authors.affiliation: Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Carmen C
authors.initials: CC
authors.lastname: Cuthbertson
authors.affiliation: Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Wener
authors.affiliation: Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Potter
authors.affiliation: Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, Chapel Hill, NC.
authors.forename: Carolyn T
authors.initials: CT
authors.lastname: Halpern
authors.affiliation: Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Ley A
authors.initials: LA
authors.lastname: Killeya-Jones
authors.affiliation: Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, Chapel Hill, NC.
authors.forename: Jon M
authors.initials: JM
authors.lastname: Hussey
authors.affiliation: Department of Biostatistics, UNC Gillings School of Global Public Health, Chapel Hill, NC.
authors.forename: Chirayath
authors.initials: C
authors.lastname: Suchindran
authors.affiliation: Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Kathleen Mullan
authors.initials: KM
authors.lastname: Harris
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D059788:Dried Blood Spot Testing / Q000379:methods*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism*; D006706:Homeostasis; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009749:Nutrition Surveys; D015995:Prevalence; D015203:Reproducibility of Results; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Diabetes mellitus; Dried blood spot testing; Glucose; HbA1c; Health surveys; Young adult