About 208,000 young people under 20 years of age in the United States had diabetes in 2012, according to the U.S. Centers for Disease Control and Prevention (CDC). While most cases of type 1 diabetes are diagnosed in those under the age of 30, the signs and symptoms often develop rapidly and the diagnosis is often made in an emergency room setting. Thus, screening for type 1 diabetes is not necessary. On the other hand, some youth with type 2 diabetes will have no signs or symptoms, especially early in the disease, and screening can be a useful tool. While still rare in children under age 10, the incidence of type 2 diabetes has increased dramatically in the last decade, especially in minority populations, according to the American Diabetes Association (ADA).
Developing the disease early in life means the individual will most likely suffer many more of the damaging blood glucose spikes associated with diabetes. This increases the risk of serious health problems earlier in adulthood, such as heart disease, kidney failure, blindness, and foot amputations due to nerve damage.
Overweight, obesity, and physical inactivity are all contributing factors to development of diabetes, and they too have become national health problems. As public health experts work to educate Americans on how to avoid this disease and its serious complications, parents and children should be aware that healthy eating habits and activity choices can lower an individual's risk of developing type 2 diabetes and related complications later in life.
A youth who is overweight—defined as a body mass index (BMI) greater than the 85th percentile for age and sex, weight for height greater than the 85th percentile, or overweight more than 120% of ideal for height— with just 2 other known risk factors faces a substantial risk of having or developing type 2 diabetes, warns the ADA. These risk factors include:
- Having a close relative with type 2 diabetes
- Being Native American, African American, Latino, Asian American, or Pacific Islander
- Having signs of or conditions associated with insulin resistance, including acanthosis nigricans, high blood pressure (hypertension), unhealthy lipid levels (dyslipidemia), or polycystic ovarian syndrome
- Having a birth mother who has diabetes or had gestational diabetes
The ADA makes the following screening recommendations:
- Consider screening overweight children who have 2 or more additional risk factors for diabetes every 3 years, starting at 10 years of age or at the onset of puberty if that occurs earlier.
- Screen using one of the following tests:
- Fasting glucose (fasting blood glucose, FBG) – this test measures the level of glucose in the blood after an 8-12 hour fast.
- A1c (also called hemoglobin A1c or glycohemoglobin) – this test evaluates the average amount of glucose in the blood over the last 2 to 3 months and has been recommended more recently as another test to screen for diabetes.
- 2-hour oral glucose tolerance test (OGTT) – this test involves drawing a fasting blood test, followed by having the person drink a 75-gram glucose drink and then drawing another sample two hours after consuming the glucose.
If the initial result is abnormal, the test is repeated on another day. If the repeat result is also abnormal, a diagnosis of diabetes is made.
Sources Used in Current Review
Centers for Disease Control and Prevention. National Diabetes Fact Sheet, 2011. PDF avaialble for download at http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf through http://www.cdc.gov. Published 2011. Accessed August 24, 2012.
American Diabetes Association. Standards of Medical Care in Diabetes – 2012. Diabetes Care. Available online at http://care.diabetesjournals.org/content/35/Supplement_1/S11.full.pdf+html through http://care.diabetesjournals.org. Published January 2012. Accessed August 27, 2012
National Diabetes Education Program. Overview of Diabetes in Children and Adolescents. PDF available for download at http://ndep.nih.gov/media/youth_factsheet.pdf through http://ndep.nih.gov. Issued June 2011. Accessed August 27, 2012.
(Updated July 28, 2014). National Diabetes Statistics Report, 2014. Centers for Disease Control and Prevention. Available online at http://www.cdc.gov/diabetes/pubs/statsreport14.htm through http://www.cdc.gov. Accessed September 2014.
(January 2014). Standards of Medical Care in Diabetes 2014. Diabetes Care Volume 37, Supplement 1. Available online at http://care.diabetesjournals.org/content/37/Supplement_1/S14.full.pdf+html through http://care.diabetesjournals.org. Accessed September 2014.