Although the prevalence of diabetes (DM) among young adults age 18 to 44 years in the United States (U.S.) has increased in the past two decades, little is known about how cardiovascular disease (CVD) risk factors for DM complications in this age group compare to older adults with DM. We used data from the National Health and Nutrition Examination Survey from 2007-2016 to characterize young adults with and without DM by CVD risk factors and compared the differences to middle- aged and older adults (aged ≥45 years). DM was defined by self-report or by A1c levels ≥ 6.5% among those without self-reported diabetes. Measures included demographics, health insurance, and CVD risk factors. Absolute difference in difference was calculated as the difference in prevalence by DM status among young adults minus the difference by DM status among middle-aged and older adults. Among young adults in the U.S., DM prevalence was 3.5%, corresponding to 3.6 million people with DM. As expected, participants of both age groups with DM had higher levels of adiposity, hypertension, high cholesterol, and chronic kidney disease (CKD), and lower levels of physical activity, compared to those without (Table). However, the difference in adiposity and high cholesterol by DM status was greater among young adults compared to middle-aged and older adults. Young adults with DM have a high burden of CVD risk factors that could lead to future increases in morbidity and mortality.


S. Saydah: None. C. Mercado: None. K.R. Siegel: None. E.W. Gregg: None. G. Imperatore: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at