Asian American and Pacific Islander (AAPI) adolescents with overweight or obesity are more than twice as likely to have prediabetes compared to their white peers, according to new research from Kaiser Permanente.

The study, published in Diabetes Care, is one of the first to take a closer look at prediabetes rates across different AAPI groups—and the numbers paint a concerning picture. Overall, about 27% of these adolescents had prediabetes, compared to just 12% of white teens with similar weight issues.

“We found that prediabetes affected about one in four AAPI adolescents who were overweight or obese,” said Dr. Joan Lo, senior author and a research scientist with Kaiser Permanente’s Division of Research. “That’s a pretty striking number, and it suggests these youth should be considered high-risk when it comes to screening.”

The study looked at more than 38,000 Kaiser Permanente Northern California members between the ages of 10 and 17. All had a BMI in the overweight or obese range and had taken a hemoglobin A1c blood test, which helps detect prediabetes and type 2 diabetes.

When researchers broke the data down by ethnic group, the results varied. South Asian teens had the highest rates of prediabetes at 31%, followed closely by Native Hawaiian and Pacific Islander youth at 32%. Filipino teens came in at 28%, Chinese at 26%, and Vietnamese at 18%.

So, what’s behind the higher rates? Experts say it’s likely a mix of things—from genetics to lifestyle habits to social factors like income, education, and access to health care.

“Our findings underscore the importance of screening,” said Dr. Adrian Matias Bacong, the study’s lead author and a researcher at Stanford’s Center for Asian Health Research and Education. “But what happens after the screening takes place is what matters. The real value in screening is that it creates an opportunity for early and meaningful intervention for diabetes prevention.”

That difference, Bacong said, could come through lifestyle changes, better nutrition, more physical activity, or clinical care—all aimed at preventing the onset of full-blown type 2 diabetes.

Diabetes is already a growing problem among young people. Rates of type 2 diabetes in U.S. adolescents nearly doubled between 2002 and 2018, rising alongside childhood obesity. And with nearly 100 million American adults living with prediabetes, health experts are increasingly focused on prevention—especially in youth.

The research was funded by Stanford’s Center for Asian Health Research and Education and Kaiser Permanente’s Division of Research.

Related