Objectives. To identify youth subgroups based on lifestyle, BMI, and sociodemographic characteristics and examine the association between group membership and prediabetes/diabetes (preDM/DM) status. Methods. We analyzed data from 1,278 adolescents (ages 12-17) from the 2011-2018 National Health and Nutrition Examination Surveys. PreDM/DM was defined using hemoglobin A1c (≥5.7 mg/dL) and/or fasting plasma glucose (≥100 mg/dL). Latent class analysis of physical activity, diet quality, screen time, and BMI identified subgroups, adjusted for sociodemographic factors. Associations between class membership and preDM/DM were assessed using survey-weighted logistic regression. Results. Four classes emerged: High BMI and unhealthy lifestyle (37.5%), Healthy BMI and physically active (25.3%), Healthy BMI and lifestyle (16.0%), and Average BMI and lifestyle (21.8%). Youth in other classes had lower odds of preDM/DM compared to the High BMI and unhealthy lifestyle class, especially the Healthy BMI and active class (aOR=0.556, 95% CI=0.327-0.946). Conclusions. Youth at risk of preDM/DM were from heterogeneous groups with varied lifestyle, health, and socioeconomic characteristics.

The authors have declared no competing interest.

This study was funded by NIH grants #R21DK131555 and #R01HG011407.

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The study used human data made publicly available through NHANES.

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