This post was written by Elizabeth Combs, RDN, certified diabetes care and education specialist, Parkview Health.
Prediabetes was once thought to primarily affect adults. However, diagnoses among children have been steadily increasing, raising concerns with healthcare professionals and parents alike. One study found that the prevalence of prediabetes in 12- to 19-year-olds more than doubled from 1999 to 2018. Today, approximately 1 in 5 children aged 12-18 are considered prediabetic.
The good news is that most people can reverse prediabetes with the right lifestyle changes. However, without intervention, children with prediabetes are at a much higher risk of developing type 2 diabetes, heart disease and other chronic diseases throughout their lives. Understanding why prediabetes is on the rise, key risk factors and what you can do to support your child's health are essential steps to preventing it.
Key risk factors
Prediabetes is a warning sign, indicating that blood sugar levels are elevated but not high enough to be classified as type 2 diabetes.
Current research shows being overweight (BMI 25-29.9), obese (BMI 30 or higher) and physically inactive play a significant role in causing prediabetes. The increasing rates of childhood obesity, largely driven by a sedentary lifestyle, excessive screentime and diets high in processed foods, have all contributed to this growing epidemic. These factors lead to insulin resistance, increasing the likelihood of prediabetes and, ultimately, type 2 diabetes.
Screening for prediabetes
The Pediatric Endocrine Society and the American Diabetes Association recommend screening for prediabetes in children at high risk. Appropriate screening tests for prediabetes can include A1c, fasting plasma glucose and/or an oral glucose tolerance test. A child is considered high risk if they meet both criteria below:
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They are age 10 or older (or younger if puberty has started) and overweight (BMI in the 85th percentile or higher)
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They have at least two of the following risk factors:
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A family history of diabetes
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Belonging to a high-risk racial/ethnic group (Native American, Black, Hispanic, Asian or Pacific Islander)
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Signs of insulin resistance:
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acanthosis nigricans
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dyslipidemia (high or low lipid levels)
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small for gestational age at birth
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A mother who had gestational diabetes
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Once screening is complete, your child's primary care doctor uses specific criteria to determine whether their levels fall within the normal range or signal prediabetes.
Keep in mind that test results outside of the normal range do not necessarily indicate prediabetes or diabetes. It's important to discuss the results with your child's provider to determine the best next steps.
Take action
Being active and making healthy dietary choices can vastly reduce your child's risk of prediabetes. Making healthy lifestyle changes as a family can create a supportive environment where everyone benefits, and healthy habits become lifelong behaviors. Here are some practical ways to implement this approach:
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Fill half your plate with fruits and vegetables. Focus on whole fruits rather than dried fruits or juices, and vary your veggies.
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Swap refined grains such as white bread for whole-grain bread.
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Enjoy a variety of proteins. Chicken, lean beef, low-fat yogurt, turkey, eggs, fish, beans, tofu and lentils are all great choices!
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Move to low-fat or fat-free dairy milk or yogurt.
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Cook at home. Include your children in planning meals and cooking to increase their interest in healthy foods. (Link to NK video)
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Eat as a family. Limit TV and phone distractions at mealtimes. Sit together for dinner and share about your day.
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Be active together. Plan family activities such as going on a walk, riding bikes or playing sports outside.
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Rethink your drink. Swap sugary drinks for water mixed with sliced fresh fruit.
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Mix it up. Try a new method of cooking veggies – for example, if your child doesn't like steamed broccoli, try roasting it with garlic and plenty of seasoning!
Learn more
Check out these posts in the Nutrition & Recipes and Sports & Exercise on the Parkview Dashboard for more tips on developing healthful eating and physical activity habits for you and your family.
For questions regarding screening and early intervention treatment, call 877-774-8632 to speak with your primary care provider or schedule an appointment. You can also reach Parkview Diabetes Care Services at 260-373-4280 to speak with a diabetes educator, registered dietitian or lifestyle change specialist.
