1291-P: Early-Onset Type 2 Diabetes in the U.S.—Prevalence from National Health and Nutrition Examination Survey (NHANES) 1999–2020 Data

Early-onset T2D, defined as diagnosed before age 40, is increasingly prevalent and may be a more aggressive disease than later-onset T2D, with faster beta cell deterioration, that is less responsive to medications. We estimated the prevalence of diagnosed and undiagnosed early-onset T2D in the US between 1999 and 2020 using the nationally representative NHANES database. Data from a longitudinal series of cross-sectional surveys of US participants conducted every two years from 1999-2020 were analyzed retrospectively. Participants with early-onset T2D were identified based on a diagnosis of T2D before age 40 (diagnosed T2D), or a fasting glucose ≥126 mg/dL or HbA1c ≥6.5% in those aged 40 years without a T2D diagnosis (undiagnosed T2D). The estimated number of participants with undiagnosed and diagnosed early-onset T2D in the US increased from 493,000 and 3,869,000 during the 1999-2000 survey cycle to 1,112,000 and 5,560,000 during 2017-2020, respectively (Figure). The prevalence rate for undiagnosed early-onset T2D increased significantly by 46% per 10-year time-period between 1999 and 2020 (OR 1.461, p0.05), whereas the rate for diagnosed early-onset T2D remained stable. NHANES data indicate that undiagnosed early-onset T2D is increasing in prevalence over time in the US, suggesting more attention is needed to diagnose and treat younger adults with T2D to improve health outcomes. Disclosure C. Lee: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. K. Boye: Employee; Eli Lilly and Company. B. Bergman: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. S.E. Williamson: Consultant; Eli Lilly and Company, Takeda Pharmaceutical Company Limited, GlaxoSmithKline plc, Novo Nordisk, Lundbeck. D.R. Nelson: Employee; Eli Lilly and Company. Funding Eli Lilly and Company