Background: Despite the epidemic of pediatric obesity, the prevalence of type 2 diabetes (T2D) during childhood remains low. Although obesity in youth portends cardiometabolic disease later in life, longitudinal data describing the progression of T2D into young adulthood are scarce.

Methods: We evaluated glycemic status (normal, prediabetes, or T2D) in a cohort of Latino youth with obesity (n=396; age 14.5±1.4; 55.6% male, BMI 33.9±5.3), and in a sub-set of participants who were re-engaged as young adults (n=39; age 20.8±1.0; 38.5% male, BMI 41.7±8.1). Glycemic status was determined from an oral glucose tolerance test with hyperglycemia classified according to ADA criteria.

Results: Among adolescents, the prevalence rates for normal, prediabetes, and T2D were 69.9%, 28.1%, and 1.3% respectively; while prevalence rates in young adults after a 5-year follow-up period were 64.1%, 25.6%, and 10.3%, respectively. Of the adolescents with normal glucose status at baseline who returned as young adults (n=28), 5 (17.9%) developed prediabetes, and 1 (3.6%) developed T2D. Of those with prediabetes at baseline (n=11), 4 (36.4%) reverted to normal glucose status, 4 (36.4%) remained prediabetic, and 3 (27.3%) developed T2D. Young adults with T2D were more likely to have a parental history of T2D than those who did not develop T2D (50% vs. 11%, p=0.04).

Conclusion: Despite strong risk factors, the prevalence of T2D among a cohort of Latino adolescents with obesity was low (1.3%). Of those who had normal glucose status during adolescence, the prevalence rate of T2D after a 5-year follow-up period was similarly low (3.6%), while for those with prediabetes during adolescence, the prevalence rate of T2D at follow-up was substantially higher (27.3%). Stratifying obese youth by glycemic status significantly affects the long-term prediction of developing T2D, which may have important implications for medical-decision making and resource allocation when managing youth with multiple T2D risk factors.


M. Olson: None. Y.P. Konopken: None. C. Keller: None. D.L. Patrick: None. A. Williams: None. S. Ayers: None. W.C. Knowler: None. A. Pena: None. E.G. Soltero: None. G.Q. Shaibi: None.


National Institute on Minority Health and Health Disparities (P20MD002316, U54MD002316); National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK107579)

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