Pre-diabetes in children
Joel Hahnke, MD, is an endocrinologist at Cardon Children's Medical Center in Mesa.
Question: Is it possible to detect a condition that develops even before a child or teenager develops Type 2 Diabetes?
Answer: Yes, this condition is called pre-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.
Most importantly, once pre-diabetes is found, there are ways to intervene so a child does not develop Type 2 Diabetes.
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. Pre-diabetes can be diagnosed with any of the following three simple blood tests:
- Glycated hemoglobin (HbA1c): This test measures the amount of blood sugar attached to hemoglobin, a protein that carries oxygen in our red blood cells. An HbA1c level between 5.7 and 6.4 percent means pre-diabetes is present. (A level of less than 5.7 percent is normal, and a level of 6.5 percent or higher means diabetes is present.)
- Fasting blood glucose (sugar) test: After fasting overnight, a blood sugar level between 100-125 mg/dL means pre-diabetes is present. (A level of 65-99 is normal, and a level of 126 or above means diabetes is present.)
- Glucose tolerance test (sugar challenge): This is a test where a child is fasting and then drinks a sugary drink, with a measure of blood sugar two hours after the drink. A two-hour sugar level of 140-199 mg/dL means pre-diabetes is present. (A level below 140 is normal, and a level of 200 or higher means diabetes is present.)
If your child is diagnosed with pre-diabetes, there are steps you should take to prevent him or her from progressing to diabetes.
The first is to change your family's eating habits. Add fruits and vegetables to every meal, and change snacks to include these.
Use water or low-calorie options to replace sugary drinks such as soda pop and juice. Read food labels to look for foods high in fiber and protein, and low in sugar and saturated or trans fats. Reduce portion sizes for meals and snacks.
The second step is to get your family moving. Start an evening walk or jog with the entire family (or a parent and child), or sign up for sports or fitness classes together.
Options like yoga, bicycling, and swimming are good for children who are not used to doing much exercise. Try to make sure your child is active for at least one hour every single day. Set a good example for your child and offer lots of support.
Finally, make sure your child sees his or her pediatrician at least once a year to monitor general health and to do standard screening tests.
These visits are the best way to catch problems like Pre-diabetes early so your child can be treated the best way possible and go on to live a healthy life.
Reviewed October 2010