Thirty-Year Glycemic Trajectories From Young Adulthood Through Middle Age
Authors' conclusion
This cohort study revealed substantial heterogeneity in glycemic trajectories across 30 years of follow-up. Clusters that represented IFG during young adulthood did not demonstrate progression to diabetes, and clusters that represented diabetes lacked prior IFG during young adulthood. These data suggest the need for strategies beyond simply screening for IFG during young adulthood to identify and target diabetes prevention for young adults.
Study context
- Population
- Adults aged 18 to 30 years enrolled in CARDIA 1985–1986, balanced on Black and White race, sex, age and educational level; excluding baseline DM, missing first 2 fasting plasma glucose (FPG) values or ≥6 FPG values2,553 [54.5%] female
- Participants
- 4,684 adults
- Outcome
- Clusters of common glycemic trajectory patterns
- Follow-up
- 30 years
Methodological detailspopulation-based, sequence analysis, 4 national community sites, Data through year 30 (2015-2016); analysis July 2023 to October 2024
- Population-based
- Sequence analysis
- 4 national community sites
- Data through year 30 (2015-2016); analysis July 2023 to October 2024
Main finding
As reported in the abstract
Glycemic trajectory patterns
- Unique glycemic trajectories identified
- 1278
- Participants with trajectories classifiable into 9 common patterns
- 3420 (73.0%)
- Brief low impaired fasting glucose (IFG) regressing to normoglycemia, younger: mean (SD) age at IFG
- 35.9 (6.6) years
- Brief low IFG regressing to normoglycemia, older: mean (SD) age at IFG
- 46.8 (3.7) years
- Younger-onset sustained IFG: mean (SD) age at IFG
- 38.6 (5.0) years
- Older-onset sustained low IFG: mean (SD) age at IFG
- 51.7 (5.1) years
- Older-onset sustained high IFG: mean (SD) age at IFG
- 41.9 (8.8) years
- Young-onset DM: mean (SD) age at DM
- 34.8 (3.6) years
- Middle-age-onset DM: mean (SD) age at DM
- 43.6 (4.4) years
- Older-onset DM: mean (SD) age at DM
- 52.4 (3.8) years
Observational data: associations, not effects.
Original publication
Thirty-Year Glycemic Trajectories From Young Adulthood Through Middle Age. JAMA Netw Open. Published 2 June 2025. doi:10.
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