Prediabetes In Children

Type 2 diabetes is on the rise. By the year 2050, one in three people will have diabetes. Children from certain racial and ethnic groups are at higher risk, including African American, Hispanic/Latino, Asian/Pacific Islander and Native American children. Just a few years ago, it was rare to hear about a child with type 2 diabetes. It used to be thought that if diabetes occurred in childhood, it was type 1, or juvenile-onset, diabetes. Not anymore. Now, according to the CDC, more than 186,000 people younger than age 20 have diabetes — both type 1 and type 2 diabetes, formerly called adult-onset diabetes.

Prediabetes is defined by plasma glucose levels that are elevated above the normal range, but below the threshold for diabetes. Early diagnosis of prediabetes identifies persons at risk and prevents progression to type 2 diabetes mellitus (T2DM) and cardiovascular disease. The glucose thresholds for prediabetes have changed over the years. Prediabetes is defined differently by the American Diabetes Association (ADA) and the World Health Organization (WHO).

A pediatrician will screen a child for pre-diabetes much in the same way as he or she screens for diabetes. The testing is done when risk factors for diabetes are present, such as obesity, darkening of the skin on the back of the neck or armpits, and a family history of Type 2 diabetes. If a child is diagnosed with pre-diabetes, it means he or she is at very high risk of developing Type 2 Diabetes. While there are no obvious symptoms that make it easy to tell whether a child has pre-diabetes, the condition can be diagnosed by a pediatrician (or other primary care provider) through routine screening at annual well visits, such as school physicals.

The new research, coordinated by the American Diabetes Association, recruited 699 children nationwide who were diagnosed with Type 2 diabetes between the ages of 10 and 17 and had had the disease on average eight months. All the children were overweight or obese. That’s why it’s so important to set kids up with healthy lifestyle habits, particularly those who are overweight or have pre-diabetes, so that full-blown Type 2 diabetes can hopefully be prevented from ever happening.

Your child does not necessarily have to be obese to be at increased risk of pre-diabetes. Simply being overweight by 20 percent or more of his ideal body weight raises your child’s risk for the disorder. Kids come in all shapes and sizes, and the way a child appears may not be reflective of his overall health. Although being overweight is a common predictor of diabetes, other factors could be putting your child at risk. For example, a family history of a blood relative with diabetes significantly increases his risk. In addition, individuals belonging to a particular race are more likely than others to develop the disease.

Although your child is not obese, your doctor may still recommend that he lose weight, as losing as little as 5 percent to 7 percent of his body weight can reduce his risk of developing diabetes by as much as 50 percent. Regardless of his weight, however, your doctor will likely emphasize the importance of dietary modification if necessary in your child’s case. Offer your child common-sense food choices that are low in sugar and calories, and high in fiber. If your child is inactive, encourage him to exercise. Walk, swim or ride bikes together for a half-hour to an hour at least five days a week. And, if your doctor prescribes a diabetic medication to your child, help him comply with that prescription. These interventions should lower your child’s fasting blood glucose level, as well as decrease his odds of developing a potentially serious disease in the future.

Celeste Botonakis

On the Nursing Assistant Guides blog, certified medical assistant Celeste Botonakis explores the daily life of a CMA. She'll keep you up-to-date with the latest on what’s happening in the field, and provides tips for those who are interested in becoming a medical or nursing assistant. Celeste has served in the medical field for over six years, and is passionate about helping people. She currently works at CSR Primary Care in Skokie, Illinois. Click here to learn more about Celeste Botonakis and