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What are the Signs of Prediabetes in Children?

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About 35 million Americans of all ages, over 10% of the total population, have diabetes. This includes some 210,000 children and adolescents under the age of 20 with a diabetes diagnosis. While type 1 diabetes is more common in children, type 2 diabetes (diabetes mellitus) is on the rise, fueled by the obesity epidemic in children. 

Type 2 diabetes (previously called adult-onset diabetes) does not appear suddenly. Many people, including children, first develop a slow, long, and invisible pre-condition to type 2 diabetes called prediabetes. In children with prediabetes, blood sugar levels are higher than normal. However, the blood glucose levels are not high enough to cause symptoms or be called diabetes. 

It is possible to prevent the progression of prediabetes to full-blown type 2 diabetes in children. Continue reading to find out more about the signs and symptoms of prediabetes in children.

What is insulin?

Insulin is a hormone made by the pancreas in the human body. It regulates blood sugar levels. When you have high blood sugar levels, the pancreas releases insulin into the bloodstream to lower blood glucose levels and keep them in the normal range. 

What is insulin resistance?

When the cells in the body stop responding to the insulin hormone, it is called insulin resistance. In people with insulin resistance, the cells in the body are unable to take up glucose from the blood. This leads to high blood sugar levels. The pancreas responds to insulin resistance by making more insulin in order to help glucose enter the cells and keep blood sugar levels in a healthy range.

What is prediabetes?

Prediabetes is a condition in which the blood sugar levels are above normal but not enough to be classified as diabetes. It usually occurs in people who have developed some insulin resistance or in whom the pancreas isn’t making enough insulin. Without enough insulin or with insulin resistance, more glucose stays in the blood rather than entering the cells to provide energy. 

Prediabetes is different from gestational diabetes (this is a type of diabetes diagnosed for the first time during gestation or pregnancy).

Most children (and adults) who develop type 2 diabetes develop prediabetes first. Over time, without lifestyle changes, prediabetes can progress to type 2 diabetes. So, you can think of prediabetes as a warning sign. It means damage to the heart, blood vessels, kidneys, and other organs has already started. In addition to increasing the risk of developing type 2 diabetes, prediabetes also increases the risk of chronic kidney disease, heart disease, stroke, and other serious health conditions.

How common is prediabetes in children?

The CDC estimates that around 18% (almost 1 in 5) teenagers (ages 12-18 years) and 1 in 4 young adults (ages 19-34 years) have prediabetes. The good news is that modifying the risk factors through healthy habits can bring blood sugar levels back to normal and prevent type 2 diabetes from developing. This includes eating a healthy diet, making regular exercise a part of your daily routine, and staying at a healthy weight.

What blood sugar levels indicate prediabetes?

Your child’s doctor can test for prediabetes by ordering blood glucose testing and other blood tests. Your child will be diagnosed with prediabetes if:

  • The results of the hemoglobin A1c blood test are between 5.7% and 6.4%.
  • The fasting blood sugar level is between 100 and 125 mg/dL.
  • The oral glucose tolerance test (OGTT) results are between 140 and 199 mg/dL (2 hours after starting the test).

What are the three symptoms of prediabetes?

Many children with prediabetes do not have any symptoms. The condition is discovered if a healthcare provider decides to test blood sugar levels due to risk factors or symptoms. However, some children with prediabetes may have symptoms, the most common being:

  • Increased thirst
  • Increased hunger
  • Frequent urination
  • Blurry vision
  • Weight loss without trying

It is important to see a healthcare provider for your child’s symptoms. They can provide medical advice about ways to reverse prediabetes and prevent the long-term consequences of diabetes.

 How do I know if my child is prediabetic?

As noted above, many adults and children with prediabetes are symptom-free. The CDC reports that only 10% of the 73 million Americans with prediabetes know that they have this condition. This is a missed opportunity to make lifestyle changes and prevent the serious long-term complications and health problems associated with diabetes.

Many people don’t know they have prediabetes because blood glucose levels are not routinely tested in children or adults. In other words, this test is not part of routine preventive care. The U.S. Preventive Services Task Force recommends blood glucose testing (screening) only in people with high blood pressure or other risk factors for diabetes. 

If your children are at an increased risk of developing diabetes mellitus (type 2 diabetes), for example, due to a family history of diabetes, talk to your healthcare providers about having your children medically reviewed or tested for prediabetes.

How long can a child have diabetes without knowing?

Not all children with prediabetes go on to develop diabetes. It is estimated that over the short term (3-5 years), roughly 25% of people with prediabetes develop full-blown type 2 diabetes. Over the long term, this percentage is significantly higher.

What to do if my child has prediabetes?

Think of your child’s prediabetes as a wake-up call. According to the American Diabetes Association, you should follow a three-pronged approach to prevent your child from ever getting diabetes. This includes:

  • Modest weight loss
  • Making healthy food choices and practicing healthy eating daily
  • Increasing physical activity (at least 30 minutes of exercise every day)

In both adults and children, these lifestyle choices can also protect against chronic health conditions like eye disease, kidney disease, heart disease, heart attack, stroke, osteoporosis, and other long-term complications. 

You can also work with a specialized diabetes health care team to develop a healthy living plan for your child. These efforts will be well worth it. Diabetes can cause damage throughout the body and result in serious long-term health problems. If a healthy diet, exercise, and being at a healthy weight are not enough to control type 2 diabetes in your child, oral medications or insulin injections may be needed.


References:

  1. https://www.mayoclinic.org/diseases-conditions/prediabetes/symptoms-causes/syc-20355278
  2. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes-in-children/symptoms-causes/syc-20355318
  3. https://www.health.harvard.edu/blog/many-miss-pre-diabetes-wake-up-call-201303266023#
  4. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance
  5. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
  6. https://www.cdc.gov/media/releases/2019/p1202-diabetes.htm
  7. https://www.diabetes.org/diabetes-risk/prediabetes