Diabetes

• Nearly 1 in 5 U.S. teens aged 12–17 has prediabetes, according to the CDC's latest analysis.
  

• The data underscores a significant silent epidemic, with most affected adolescents unaware of their condition.
  

• Health experts urge increased screenings, especially for at-risk groups, and better public awareness.

A new analysis from the Centers for Disease Control and Prevention (CDC) has identified a troubling trend: nearly 1 in 5 American adolescents between the ages of 12 and 17 is living with prediabetes. 

The findings are based on data collected from the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample that combines interviews, physical exams, and laboratory testing.

Prediabetes, a condition in which blood sugar levels are elevated but not yet high enough to qualify as type 2 diabetes, is considered a major warning sign. In the CDC analysis, prediabetes was diagnosed using two key indicators: a fasting plasma glucose (FPG) level between 100 and 125 mg/dL, or a hemoglobin A1c level between 5.7% and 6.4%. Adolescents already diagnosed with diabetes were excluded from the analysis.

What makes the situation more alarming is that prediabetes typically occurs without symptoms, especially in younger populations. That means many adolescents and their families may be unaware of the metabolic changes occurring, despite the long-term health risks they pose, including progression to type 2 diabetes, heart disease, and kidney complications.

Behind the numbers

The CDC used updated FPG calibration methods to ensure accuracy across multiple NHANES data collection cycles. Older prediabetes estimates—such as the 2020 study by Andes et al.—used a different adjustment method, making this new analysis a more refined look at how widespread the issue has become.

To confirm diabetes status, researchers relied on both interview responses and lab results. Adolescents were classified as diabetic if they either answered “yes” to having been diagnosed by a healthcare provider or had lab-confirmed results with FPG ≥126 mg/dL or A1c ≥6.5%.

Physicians say the findings underscore the urgent need for earlier interventions, particularly as lifestyle factors like sedentary behavior, poor diet, and obesity continue to climb among youth populations. The CDC and other public health organizations have long recommended increased screening for children with risk factors such as obesity, family history of diabetes, or signs of insulin resistance.

Losing weight is something nearly every American wants to do but, like a lot of things, it's not always good for your health. Case in point: xylitol, the sugar substitute that's used in a lot of low-calorie foods.

Consumers with diabetes and those trying to lose weight choose artificial sweeteners to safeguard their health. But now, a new study by Cleveland Clinic researchers published in the European Heart Journal finds that xylitol carries an increased risk of heart attack and stroke.  

The study, published this week, examined the effects of xylitol on blood clotting and cardiovascular events. While researchers caution that their findings do not prove cause-and-effect, the results indicate a strong association between xylitol levels and cardiovascular risk.

Xylitol and cardiovascular events

The first part of the study analyzed blood plasma samples from over 3,000 fasting individuals who had participated in an earlier study. These individuals had been followed for three years, and some had experienced major cardiovascular events such as heart attacks or strokes.

When comparing their blood samples, researchers found that those who suffered a cardiovascular event had significantly higher blood levels of xylitol than those who did not.

How Xylitol affects blood clotting

To further explore the potential risks, researchers conducted lab tests on human blood and mice models.

• In human blood samples, they found that xylitol increased platelet activity, causing the blood to clot more easily.
• In mice, they injured the carotid artery and observed an accelerated rate of clot formation in those exposed to xylitol.

Since blood clots can travel to arteries and veins in major organs, they can increase the risk of heart attacks, strokes, and even death.

Testing on volunteers

The researchers also conducted a small human trial to test how quickly xylitol could affect blood clotting. They gave 10 healthy volunteers a drink sweetened with xylitol and measured their blood clotting ability before and 30 minutes after consumption.

• Results showed a rapid increase in clotting ability in those who consumed the xylitol drink.
• In contrast, volunteers who drank glucose or other sugar-sweetened beverages showed no changes in blood clotting.

What it means for consumers

While the findings are concerning, researchers stress that the study does not prove xylitol directly causes heart attacks or strokes.

“We need to determine whether this effect is unique to xylitol or common among all sugar alcohols,” said Dr. Stanley Hazen, a cardiologist and lead researcher of the study.

Until more research is done, experts advise consumers to be mindful of sugar substitutes and their potential health risks.

Novo Nordisk, the maker of Ozempic, reported that compounded versions of semaglutide, the main ingredient in Ozempic and Wegovy, have led to at least 100 hospitalizations and 10 deaths.

CEO Lars Fruergaard Jorgensen expressed concern, stating that only Novo Nordisk makes real semaglutide and does not supply it to others.

“Honestly, I’m quite alarmed by what we see in the US now,” Novo Nordisk President and CEO Lars Fruergaard Jorgensen told CNN. “Patients who believe that they’re getting access to a safe product, and they believe they’re getting semaglutide … I know for a fact that they are not getting semaglutide, because there’s only one semaglutide, and that’s produced by Novo Nordisk, and we don’t sell that to others.”

Compounded drugs, created by other pharmacies when there’s a shortage, are not FDA-approved and may carry risks. The FDA’s database includes reports of adverse effects with compounded semaglutide, including dosing errors and cases involving a salt form of the drug that differs from the approved version.

Semaglutide is still on the FDA’s shortage list, though Novo Nordisk is working to resolve it. The FDA is evaluating supply and demand and monitoring for patient safety.

About semaglutide

Semaglutide is a medication that mimics the glucagon-like peptide-1 (GLP-1) hormone, which plays a crucial role in regulating blood sugar levels and appetite. It is marketed under brand names such as Ozempic, Wegovy, and Rybelsus, each approved for specific uses:

• Ozempic: Approved for managing type 2 diabetes and reducing the risk of major cardiovascular events in adults with type 2 diabetes and known heart disease.

• Wegovy: Approved for chronic weight management in adults with obesity or overweight conditions, in conjunction with a reduced-calorie diet and increased physical activity.

• Rybelsus: An oral form of semaglutide approved for improving blood sugar control in adults with type 2 diabetes.

Reasons for Semaglutide's Popularity:

1. Effective Weight Loss: Clinical trials have demonstrated that semaglutide can lead to significant weight loss, making it a popular choice for individuals seeking to manage obesity.

2. Improved Blood Sugar Control: For patients with type 2 diabetes, semaglutide effectively lowers blood sugar levels, aiding in disease management.

3. Cardiovascular Benefits: Semaglutide has been shown to reduce the risk of major cardiovascular events, such as heart attack and stroke, in individuals with type 2 diabetes and existing heart disease.

4. Convenient Dosing Options: Available in both injectable (once-weekly) and oral (daily) forms, semaglutide offers flexibility to suit patient preferences.

5. Broader Health Benefits: Emerging research suggests potential benefits of semaglutide in reducing risks of conditions like colorectal cancer and kidney disease, further enhancing its appeal.

While semaglutide offers numerous benefits, it's important to be aware of potential side effects, including gastrointestinal issues and, in rare cases, more serious adverse effects. Consulting with a healthcare provider is essential to determine if semaglutide is appropriate for individual health needs.

Millions of people have diabetes and almost all of them first had a condition known as pre-diabetes.

Now, federal medical researchers have discovered a simple tool to alert doctors that a patient is at risk for pre-diabetes and on the path to the full disease.

The tool is simple and costs nothing. A patient is administered an oral glucose tolerance test and the time it takes to reach maximum sugar level is recorded. Those who take longer to reach that maximum threshold are at greater risk of pre-diabetes, the researchers found.

“Our research may help clinicians and public health officials guide patients to better and more cost-effective decisions about risk for pre-diabetes” said Stephanie Chung, M.B.B.S., the study’s first author and an assistant clinical investigator at the National Institute of Diabetes and Digestive and Kidney Diseases, which is part of the National Institutes of Health (NIH).

The implications

The implications are fairly clear. By giving the glucose test and noting the time to reach maximum levels, doctors can get a heads-up that the patient is at risk for developing pre-diabetes, placing them at even greater risk of developing type-2 diabetes.

Simply put, having pre-diabetes means your blood sugar level is higher than normal but not yet high enough to be type-2 diabetes. It's not a given that pre-diabetes turns into full-blown type-2 diabetes, but it happens a lot.

However, with significant lifestyle changes – eating a nutritious diet and getting plenty of exercise – a patient can return his or her blood glucose levels to normal. In fact, there have been cases where people with type-2 diabetes have actually reversed the disease with radical lifestyle changes.

Early damage

However, the Mayo Clinic warns that if you have developed pre-diabetes, you may already be suffering the long-term damage of diabetes.

Unfortunately, pre-diabetes has no obvious symptoms. However, Mayo Clinic doctors say subtle signs include darkening skin in certain parts of the body. You may be at risk for pre-diabetes if you are overweight, eat an unhealthy diet, and get little exercise.

Type-2 diabetes is a serious condition. It's triggered when your body starts having trouble using insulin, which transports glucose into cells. When that happens you are at risk of building up too much glucose in your blood.