The Prevalence and Distribution of Diagnosed and Undiagnosed Type Two Diabetes Mellitus Among Young Adults Aged 20-40 Years, Utilizing NHANES Data from 1999-2010
Creators: name: Roach, Zachary
Publisher: name: Georgia State University
Year: 2014

description: Background
Within the last century, Type 2 diabetes mellitus has become one of the major health concerns both in the US and globally.  Overall prevalence and incidence of the disease within younger populations including adolescents and young adults has sharply increased since 1990 and is estimated to increase further if no actions are taken.   It is estimated that 5.7 million people have a form of diabetes. Of the total estimated prevalence of T2DM, 25% of persons with diabetes are unaware they have the disease.  This study aims to identify populations most at risk as well as to label important risk factors associated with the rise of T2DM within the young adult population.    
Objectives
This study aimed to measure the prevalence of diagnosed and undiagnosed T2DM among different populations based on ethnicity, socioeconomic status, and weight classification among a representative sample of young adults within the United States.  This study also aims to identify and quantify associated risk factors of T2DM among young adults, and address current preventative and treatment measures. 
Methods
Six two-year samples of the National Health and Nutrition Examination Survey (NHANES) containing a total of 62,160 individuals were compiled into one dataset.  Of these, 11,874 young adults aged 20-40 were selected into the study.  Prevalence of diagnosed and undiagnosed T2DM was calculated for specific populations. The study also aimed to identify important risk factors through univariate and multivariate binomial logistic regression analysis.  
Results
Among young adults aged 20-40, overall prevalence of T2DM was found to be 1.4% (CI: 1.2-1.6%).  Of observed diabetes cases, an alarming 20.1% (N = 68) were categorized as undiagnosed.  Significant increases in risk were observed within older age groups, overweight and obese weight categories, individuals living below poverty and within minority racial/ethnic groups.
Weight, measured by both BMI (OR: 10.7; CI:5.88-19.44) and waist circumference (OR: 5.29; CI: 3.18-8.79), was identified as the most influential risk factor, and should be a main area of focus in development of interventions.  Increases in activity levels, both at work and during leisure-time, were found to decrease one’s risk of having T2DM.   
Discussion
Type 2 diabetes has become a major health concern within the past decades, and will continue to be an area of focus in the future.  If current trends of diabetes among the young continue, significant burden will be placed on both health facilities as well as on the economy.  Based on the findings from this study, further research should be place on prevention methods aimed at altering life-style behaviors such as diet and exercise early in one’s life.  Based on the alarming prevalence of undiagnosed cases, continued research and support should also be place on access to care for minorities, especially persons of Latin American decent.