Prediabetes is on the rise in adolescents: Here’s what parents can do to help

More kids and teens are being diagnosed with prediabetes than in the past, but there are things parents can do to delay or prevent diabetes.

Incidences of prediabetes in kids and teens in America are growing at an concerning rate, according to a new study published in the JAMA Pediatrics journal.¹

Researchers looked at National Health and Nutritional Examination Survey responses from around 6,600 12- to 19-year-olds collected between 2015 and 2018 and found that nearly 30% of respondents were prediabetic. This is more than double the number of teens and adolescents that reported signs of prediabetes 20 years prior.

We spoke with Ali Stith, a registered pharmacist with Express Scripts® Pharmacy, about what prediabetes is, the biggest risk factors, and what parents can do to prevent their kids from developing full-blown type 2 diabetes.

What is prediabetes?

Prediabetes is when someone has higher blood sugar levels than normal, but not high enough to be diagnosed with type 2 diabetes. This is typically a fasting blood sugar between 100mg/dL and 125 mg/dL and an A1C between 5.7% and 6.4%.

Even though prediabetes is not diabetes, it does raise a person’s risk of developing type 2 diabetes in the future, as well as other chronic health conditions such as heart disease and stroke.

Understanding the risk factors for prediabetes

“Previously young children and teens almost never got diabetes or prediabetes,” explained Stith. But that isn’t the case anymore.

Stith believes this is in part because more children are overweight and obese.

“Those with excess belly fat are more likely to have insulin resistance,” said Stith. “Insulin resistance is a major risk factor for type 2 diabetes.”

One study found that obese adolescents were up to four times more likely to develop type 2 diabetes than those with a BMI in the normal range.

In addition to excess weight, lack of physical activity and genetics also can play a role in a child’s risk of developing prediabetes.

Warning signs of prediabetes

Screening in youth is essential because prediabetes doesn’t always show symptoms.

“Many don’t know they have the condition until they have full-blown diabetes,” said Stith.

Pediatricians recommend screening children for prediabetes if they meet all of these criteria:

• They’re 10 or older (or approaching puberty since hormones during puberty make it harder for the body to use insulin).
• They have a BMI at or above the 85th percentile.
• They have one or more of the following risk factors: a family history of diabetes, signs of insulin resistance, high blood pressure, high cholesterol, or fall into an at-risk race or ethnic group.

What parents can do to help prevent diabetes

“Managing prediabetes means preventing diabetes,” said Stith.

For some people that simply means making lifestyle changes like exercising more, eating healthier, and reducing stress.

Stith recommends making these changes together as a family.

“Teenagers often want to be treated as adults and take control of their own lives,” said Stith.

She suggests getting them involved in the process as much as possible, whether it be through joint meal planning, active family outings, or using wearable technology like fitness and calorie trackers to make the process more fun and interactive.

There are also a number of CDC-recognized lifestyle change programs available for kids and teens. Research shows that lifestyle change programs can cut the risk of developing type 2 diabetes by more than half.²

If lifestyle changes aren’t enough to improve blood sugar levels, pediatricians may prescribe metformin.

Our pharmacists can help

If your child has been diagnosed with prediabetes or you have concerns your child is at risk for developing diabetes, Express Scripts® Pharmacy is here to help. Our Diabetes Therapeutic Resource Center gives you 24/7 access to specially trained pharmacists who can answer any of your questions and concerns regarding prediabetes prevention and treatment, as well as advise you on preventive medication options.

1 JAMA Network: Trends in Prediabetes Among Youths in the US From 1999 to 2018 (March 28, 2022): https://jamanetwork.com/journals/jamapediatrics/article-abstract/2790364.
2 Centers for Disease Control and Prevention: Lifestyle Change Program Providers (accessed July 21, 2022): https://www.cdc.gov/diabetes/prevention/program-providers.htm.