Skip to Content
800-533-8762
  • Careers
  • Newsroom
  • Health Care Professionals
  • About Us
  • Contact Us
UPMC
  • Find a Doctor
  • Services
    • Frequently Searched Services
    • Frequently Searched Services
      Allergy & Immunology Behavioral & Mental Health Cancer Ear, Nose & Throat Endocrinology Gastroenterology Heart & Vascular Imaging Neurosciences Orthopaedics
      Physical Rehabilitation Plastic & Reconstructive Surgery Primary Care Senior Services Sports Medicine Telemedicine Transplant Surgery Walk-In Care Weight Management Women’s Health
      See all Services
    • Services by Region
    • Find a UPMC health care facility close to you quickly by browsing by region.
      UPMC in Western Pa. Western Pa. and New York
      UPMC in Central Pa. Central Pa.
      UPMC in North Central Pa. North Central Pa.
      UPMC in Western Md. Maryland & West Virginia
    • See All Services
  • Locations
    • Locations by Type
    • Locations by Type
      UPMC hospitals
      Hospitals
      Physical Therapy
      Physical Therapy
      Urgent care
      Walk-In Care
      UPMC Outpatient Centers
      Outpatient Centers
      UPMC Imaging Services
      Imaging
      Community Health Centers
      Community Health Centers
      See All Locations
    • Locations by Region
    • Locations by Region
      UPMC in Southwest Pa. Southwest Pa.
      UPMC in North Central Pa. North Central Pa.
      UPMC in Northwest Pa and Ny. Northwest Pa. & Western N.Y.
      UPMC in West Central Pa. West Central Pa.
      UPMC in Central Pa. Central Pa.
      UPMC in Western Md. Maryland & West Virginia
    • See All Locations
  • Patients & Visitors
    • Patient & Visitor Resources
    • Patient & Visitor Resources
      Patients and Visitors Resources Pay a Bill Classes & Events Medical Records Health Library Patient Information
      Patient Portals Privacy Information Shared Decision Making Traveling Patients Visitor Information
      Man uses mobile phone
      Pay a Bill
      Nurse reviews medical chart
      Request Medical Records
  • Patient Portals
  • Find Covid-19 updates
  • Schedule an appointment
  • Request medical records
  • Pay a bill
  • Learn about financial assistance
  • Find classes & events
  • Send a patient an eCard
  • Make a donation
  • Volunteer
  • Read HealthBeat blog
  • Explore UPMC Careers
Skip to Content
UPMC
  • Patient Portals
  • For Patients & Visitors
    • Find a Doctor
    • Locations
    • Patient & Visitor Resources
    • Pay a Bill
    • Services
    • More
      • Medical Records
      • Financial Assistance
      • Classes & Events
      • HealthBeat Blog
      • Health Library
  • About UPMC
    • Why UPMC
    • Facts & Stats
    • Supply Chain Management
    • Community Commitment
    • More
      • Financials
      • Support UPMC
      • UPMC Apps
      • UPMC Enterprises
      • UPMC International
  • For Health Care Professionals
    • Physician Information
    • Resources
    • Education & Training
    • Departments
    • Credentialing
  • Careers
  • Contact Us
  • Newsroom
  • UPMC >
  • Media Relations >
  • News Releases >
  • 061124 youth onset prediabetes
Media Relations
News Releases
Central Pa. News
North Central Pa. News
Contact Us
Experts
Community-Focused News
Media Kits
Media RSS
Media Relations
News Releases
Central Pa. News
North Central Pa. News
Contact Us
Experts
Community-Focused News
Media Kits
Media RSS

Chat Keywords List

  • cancel or exit: Stops your conversation
  • start over: Restarts your current scenario
  • help: Shows what this bot can do
  • terms: Shows terms of use and privacy statement
  • feedback: Give us feedback
Continue
Chat with UPMC
RESTART
MENU
CLOSE

Social Determinants of Health Linked with Youth-Onset Prediabetes

For Journalists

Asher Jones
Manager, Science Writing
412-647-3555
jonesag@upmc.edu

Andrea Yorchuck (Kunicky)
Senior Manager
412-552-7448
KunickyA@upmc.edu

Want to Make an Appointment or Need Patient Information?
Contact UPMC at

1-800-533-8762.

Go to Find a Doctor to search for a UPMC doctor.

2023 PITT HS

6/11/2024

PITTSBURGH — Food insecurity, low household income and not having private health insurance are associated with higher rates of prediabetes in adolescents, independent of race and ethnicity, according to a new JAMA Network Open study by University of Pittsburgh and UPMC researchers.

The findings suggest that screening for social determinants of health — the non-medical factors that influence a person's health and risk of disease — may help identify youth at risk of prediabetes, which could ultimately improve early interventions that prevent progression to type 2 diabetes.

“TVAJRAVELU_MARY_ELLEN_MD1his study underscores the importance of using social factors, which are modifiable — meaning that we can address them — to understand and reduce diabetes risk in adolescents as opposed to personal, non-modifiable characteristics like race and ethnicity,” said senior author Mary Ellen Vajravelu, M.D., M.S.H.P., assistant professor of pediatrics at Pitt and pediatric endocrinologist at UPMC Children's Hospital of Pittsburgh. “Many medical guidelines are moving away from the use of race and ethnicity to determine care and screening practices because it can exacerbate disparities instead of reducing them.” 

Prediabetes is defined by higher-than-normal blood sugar, which can progress to type 2 diabetes if not addressed with lifestyle changes such as diet and exercise. 

“In our clinic we see a lot of adolescents with type 2 diabetes, which is a very serious condition when it starts in childhood,” said Vajravelu. “Current guidelines for identifying children at high risk for type 2 diabetes and prediabetes use characteristics such as body size, race, ethnicity and family history, but those risk factors still don't fully explain who presents with type 2 diabetes in childhood.”

According to Vajravelu, type 2 diabetes and prediabetes are more prevalent among youth who identify as Native American, Alaska Native, Asian, Black and Hispanic than their white counterparts. However, because these minoritized groups are also more likely to experience adverse social determinants of health, it is likely these social factors, rather than race itself, that influence disease risk. 

To better understand the role of social determinants of health in youth-onset prediabetes, Vajravelu and her team used a large national database to identify 1,563 participants aged 12 to 18 years and with obesity, 8.5% of whom had elevated blood glucose, or hemoglobin A1c, indicating prediabetes. Then, they looked at three social determinants of health related to diabetes management: food security, health insurance and household income.

Adverse scores for all three were linked with prediabetes risk: Prevalence of prediabetes was 4.1% higher among participants from households with food insecurity compared to those with food security, 5.3% higher in youths with public compared to private insurance, and 5.7% higher in youths with household income at less than 130% of the federal poverty level compared to those with higher incomes.

The associations of these risk factors with prediabetes also differed within racial and ethnic groups, underscoring the importance of considering social determinants of health when understanding type 2 diabetes risk.

For example, in white children, who are traditionally considered at lower risk for prediabetes, going from having one to two or three adverse social determinants of health quadrupled the prevalence of prediabetes.

“If we use race and ethnicity to guide us in identifying children at risk of prediabetes, it could steer us away from screening children who do not fall into a higher risk race or ethnicity category,” said Vajravelu. “Instead, if we tailor our screenings based on exposure to risk factors, not race, we might be able to pick up additional children who are at risk for diabetes.”

Adverse social determinants of health could influence diabetes risk in several ways. For example, families experiencing food insecurity are less likely to have access to healthy foods to prevent diabetes and those without private insurance may have more limited access to health care.

There are many more social factors that could also impact diabetes risk that the researchers did not look at in this study, including diet quality and healthy lifestyle factors. Including additional factors could improve identification of children at risk for prediabetes in the future.

A limitation of the study is that hemoglobin A1c levels were from just one snapshot in time and the researchers were not able to track whether children went on to develop diabetes or not.

In follow-up research, Vajravelu and coauthor Maya Ragavan, M.D., M.P.H., M.S., assistant professor of pediatrics at Pitt, plan to collaborate with community partners to investigate how addressing food insecurity, housing instability and other health-related social needs could improve clinical outcomes for patients with diabetes. 

Other authors on the study were Caleb Harrison, Adriana Rodríguez González, M.D., Rutha Chivate, Xu Qin, Ph.D., Margaret Zupa, M.D., M.S., all of Pitt or UPMC; and Vaishnavi Peyyety, of Washington & Jefferson College.

This research was supported by Washington & Jefferson Merck Internship for Excellence in Science Program, the National Institutes of Health (DK065521, K23HD104925, K23DK125719 and KL2TR001856), the Endocrine Fellows Foundation, the Tanner Scholar Advancing Equity grant and UPMC Children’s Hospital of Pittsburgh Health Equity Award.


PHOTO DETAILS: (click image for high-res version)

CREDIT: UPMC
CAPTION: Mary Ellen Vajravelu, M.D., M.S.H.P., assistant professor of pediatrics at Pitt and pediatric endocrinologist at UPMC Children's Hospital of Pittsburgh.

UPMC
200 Lothrop Street Pittsburgh, PA 15213

412-647-8762 800-533-8762

Patients And Visitors
  • Find a Doctor
  • Locations
  • Pay a Bill
  • Patient & Visitor Resources
  • Disabilities Resource Center
  • Services
  • Medical Records
  • No Surprises Act
  • Price Transparency
  • Financial Assistance
  • Classes & Events
  • Health Library
Health Care Professionals
  • Physician Information
  • Resources
  • Education & Training
  • Departments
  • Credentialing
Newsroom
  • Newsroom Home
  • Inside Life Changing Medicine Blog
  • News Releases
About
  • Why UPMC
  • Facts & Stats
  • Supply Chain Management
  • Community Commitment
  • Financials
  • Supporting UPMC
  • HealthBeat Blog
  • UPMC Apps
  • UPMC Enterprises
  • UPMC Health Plan
  • UPMC International
  • Nondiscrimination Policy
Life changing is...
Follow UPMC
  • Contact Us
  • Website/Email Terms of Use
  • Medical Advice Disclaimer
  • Privacy Information
  • Active Privacy Alerts
  • Sitemap
© 2025 UPMC I Affiliated with the University of Pittsburgh Schools of the Health Sciences Supplemental content provided by Healthwise, Incorporated. To learn more, visit healthwise.org
Find Care
Providers
Video Visit
Portal Login