Background: Prediabetes disproportionally affects US Latino adolescents. However, it is unclear which characteristics or modifiable lifestyle behaviors captured in the electronic health record (EHR) are associated with prediabetes among Latino adolescents. Addressing this knowledge gap was the objective of this study.

Methods: Cross-sectional data was used from 8,946 Latino adolescents ages 13-17 years in northern California with a well-child visit in 2016-20 and BMI ≥95th percentile. Characteristics and modifiable lifestyle behaviors of interest included age, gender, household language preference (English/Spanish) , neighborhood deprivation index (NDI, quartiles) , obesity class and 4 self-reported daily obesogenic behaviors captured during the visit: 1) consuming <5 servings of fruits/vegetables; 2) drinking ≥12 oz juice/soda; 3) exercising for <60 minutes; and 4) >2 hours of screen time. Prediabetes was ascertained within 1 year of the health visit and was classified as HbA1c 5.7-6.4%. Multivariate logistic regression was used to examine the association between the variables of interest and prediabetes.

Results: Among 8,946 Latino adolescents with obesity, 15.4% had prediabetes. Having class 3 obesity (OR of 2.7; [95% CI: 2.3-3.1], living in a Spanish-speaking household (1.15; 1.0-1.3) and engaging in low exercise (OR 1.12; 0.99-1.3) were all independently associated with increased odds of prediabetes, though exercise was only marginally significant at a p-value <0.1. Age, gender, NDI, and diet were not independently associated with prediabetes.

Conclusion: Among Latino adolescents with obesity, 1 in 7 had prediabetes. Our findings suggest that strategies targeting obesity and promotion of physical activity, particularly among adolescents living in Spanish-speaking households, may have the most success in preventing diabetes among Latino adolescents with prediabetes.


A. Gopalan: None. M. Chandra: None. J.A. Darbinian: None. L. Greenspan: None. J.C. Lo: None.


The Permanente Medical Group (TPMG) Health Care Delivery and Policy Section Pilot Award. TPMG (Delivery Science Fellowship Program) . Kaiser Permanente Northern California Graduate Medical Education Research Community Benefit Program. National Institutes of Health (T32DK11668401) .

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