Prediabetes

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KEY POINTS

• Prediabetes means that your child’s blood glucose (sugar) levels are higher than normal but not high enough to be diabetes.
• Treatment includes healthy lifestyle changes such as losing weight if needed, eating a variety of healthy foods, and physical activity. Your child may need medicine to help control blood glucose levels.
• It is possible to prevent or delay prediabetes from becoming diabetes, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment.

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What is prediabetes?

Diabetes is a problem with the way the body makes or uses insulin. Insulin is made by the pancreas, which is an organ in the upper belly. The body uses insulin to help move glucose (sugar) from the blood into the cells. When the body does not make enough insulin or has trouble using the insulin the body makes, glucose cannot get into the cells and builds up in the blood.

Prediabetes means that your child’s blood glucose levels are higher than normal but not high enough to be diabetes.

Prediabetes is found in children and teens even though it’s more common in adults as they age.

What is the cause?

Prediabetes may be caused by:

• Insulin resistance, which means your child’s body makes enough insulin, but the cells are not able to use it properly. Insulin is a hormone made by the pancreas, which is an organ in the upper belly. Your child’s body breaks down some of the foods your child eats into glucose. Then, it uses insulin to help move glucose from the blood into your child’s cells for energy.
• Your child’s pancreas not making enough insulin for the body’s needs

Your child’s risk is higher if your child:

• Is overweight or has obesity
• Has a family history of type 2 diabetes, including a mother who had gestational diabetes
• Doesn't get enough physical activity
• Is a teenage girl who has polycystic ovary syndrome (PCOS)
• Is of African American, Alaska Native, American Indian, Hispanic/Latino, Asian American, or Pacific Islander descent

What are the symptoms?

Most children with prediabetes do not have symptoms. Some children have thickened, darkened skin on the neck or in body folds such as under the arms. This condition is called acanthosis nigricans. The problems that come from prediabetes develop over time.

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. You child may have these tests:

• Fasting blood glucose level
• A1C level, which measures average blood glucose over the past 3 months
• Oral glucose tolerance test (OGTT), which measures the body’s response to glucose over 2 hours

How is it treated?

The most important part of treatment is making healthy lifestyle changes:

• Help your child start with small changes.
• Your child’s healthcare provider will give you guidelines about which foods your child should eat and which to limit or avoid. Help your child learn about portion size. Your child’s provider may refer you to a dietitian or certified diabetes educator for help with healthy meal planning.
• More physical activity as advised by your child’s healthcare provider will help your child feel more fit, have more energy, and help lower blood glucose levels. Try to aim for an hour of active play a day.

If lifestyle changes don’t lower your child’s risk enough, your healthcare provider may prescribe medicine to help lower your child’s blood glucose level.

How can I take care of my child?

It is possible to prevent or delay prediabetes from becoming diabetes, mainly with lifestyle changes. Your child can’t change risk factors such as family history or ethnicity, but you can help your child change lifestyle risk factors around eating, physical activity, and weight. A healthy lifestyle is a lifelong commitment.

Follow the full course of treatment prescribed by your child’s healthcare provider. In addition, make sure that your child:

• Chooses a variety of healthy foods such as whole grains, fruits, beans, nuts, vegetables, lean meat, and fish. Teach your child to include fat-free or low-fat milk products, including soy or almond milk.
• Eats foods low in saturated fat, trans fat, and simple carbohydrates (carbs) such as candy, sugar, and baked goods. Teach your child to avoid the white food such as white bread, chips, crackers, fries, cookies, biscuits, pancakes, white potatoes, and white rice.
• Avoids foods and drinks that are high in added sugar. For example, teach your child to choose water instead of sugary drinks such as soda and juice.
• Stays physically active as advised by your child’s provider. Ask your provider to give you a physical activity plan that tells you what kind of activity, and how much, is safe for your child. It’s best if your child starts slowly to avoid injury. You can involve your child’s teachers or coach as needed to support your child’s physical activity plan.
• Loses weight if your child is overweight and keeps a healthy weight according to your child’s healthcare provider’s advice.

Your child’s healthcare provider may suggest other changes that support a healthy lifestyle, including:

• Don’t smoke and avoid secondhand smoke.
• Get enough sleep by having good sleep habits and a regular sleep routine. If your child regularly has trouble getting enough sleep, talk to your child’s healthcare provider.

Your child should have his or her blood glucose levels and weight checked as often as advised by your child’s healthcare provider.

Ask your child’s provider:

• How and when you will get your child’s test results
• If there are activities your child should avoid
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.