Is Your Child at Risk of Pre-diabetes?

Pre-diabetes is one of the risk factors for cardiovascular disease and diabetes mellitus. Some health-care experts consider pre-diabetes as a disease. Certain adults (five to ten per cent) with this condition normally advance to type 2 diabetes mellitus. However, adolescents and children with pre-diabetes have an ability to return to normal than adults.

Certain factors increase the risk of pre-diabetes in children. They include both modifiable and non-modifiable risk factors.

• Age
• Sex
• Ethnicity
• Puberty
• Obesity
• Family history of diabetes mellitus
• Cardiometabolic risk factors

Age

Children aged 12-15 years have a higher rate of pre-diabetes compared to individuals aged 16-19 years(1). This can be associated with the maximum pubertal insulin resistance, which develops in early adolescence.

Sex

The incidence of pre-diabetes is 2.4 times higher in boys than girls(1).


Ethnicity

Pre-diabetes occurs in individuals of all races. However, some ethnic groups have a greater risk of developing pre-diabetes and diabetes than others. Prevalence of diabetes is higher among people aged more than 25 years in Marshall Islands, Kiribati, Samoa, Saudi Arabia, Cook Islands, Dominica, Tonga, Palau, Jordan, and Solomon Islands compared to other countries (WHO report 2008).

Puberty

Among overweight adolescents and children, puberty is linked with a higher risk of developing pre-diabetes. Usually, they have a lower risk of pre-diabetes during their prepubertal period.

Obesity

Different studies show various rates of pre-diabetes among obese children. However, the incidence of pre-diabetes is higher in obese adolescents and children. Impaired glucose tolerance (IGT) was noted in 25 % of children, who are obese and aged four to ten years. It was 21 % in obese adolescents aged between 11 and 18 years(2). Obese adolescents also have a 2.6 times higher risk of pre-diabetes compared to adolescents with normal weights(1).

Family history of diabetes mellitus

Family history of diabetes mellitus is a strong risk factor for pre-diabetes and diabetes. In addition, the existence of positive family history of diabetes in a first-degree relative is linked with pre-diabetes, even without obesity.

Cardiometabolic risk factors

If an adolescent has two or more cardiometabolic risk factors, like dyslipidaemia, high blood pressure (hypertension), and hypertriglyceridaemia, he or she will have a 2.7 times higher risk of developing pre-diabetes compared to those without such risk factors(1). Likewise, adolescents, who are with hyperinsulinaemia have a four times higher incidence than individuals with no cardiometabolic risk factors.

Testing for pre-diabetes appears to be important in adolescents and children, who are very obese, have a parental diabetic history, have achieved puberty, and belong to certain ethnic groups.



Related Links:

How Do You Know You Have Pre-diabetes?
Pre-diabetes: Development in Children
How to Manage Pre-diabetes in Children?
What is Diabetes Mellitus?

References

1.    Li C, Ford ES, Zhao G, Mokdad AH. Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among U.S. adolescents: National Health and Nutrition Examination Survey 2005-2006. Diabetes Care. 2009;32:342-347.

2.    Sinha R, Fisch G, Teague B, et al. Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med. 2002;346:802-810.