About 193,000 young people under 20 years of age in the United States had diabetes in 2015, 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 18, the signs and symptoms often develop rapidly and the diagnosis is often made in an emergency room setting. Thirty percent of new-onset cases of type 1 diabetes in children present with diabetic ketoacidosis. Thus, blood glucose measurements as screening for type 1 diabetes in asymptomatic children is presently not necessary. On the other hand, some youth with type 2 diabetes will have no obvious signs or symptoms of high blood glucose, especially early in the disease, and screening can be a useful tool. While still uncommon in children under age 10, the 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 that the patient is at increased risk for the development of diabetic complications because of the potentially prolonged duration of exposure to high blood glucose (hyperglycemia). This increases the risk of serious health problems earlier in adulthood, such as heart disease, kidney failure, blindness, and foot amputations.
Overweight, obesity, and physical inactivity are all contributing factors to development of type 2 diabetes, and they too have become national health problems. As public health experts work to educate Americans on how to avoid diabetes 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— plus 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, such as , high blood pressure (hypertension), unhealthy lipid levels (), polycystic ovary syndrome, or having a reduced birth weight (small-for-gestational age)
- 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.
- Hemoglobin A1c (also called A1c or glycated hemoglobin) – this test evaluates the average amount of glucose in the blood over the last 2 to 3 months and has been recommended as another test to screen for diabetes.
- 2-hour oral glucose tolerance test (OGTT) – this test involves drawing a fasting blood sample for glucose measurement, followed by having the person drink a solution containing 1.75 g of glucose per kilogram body weight to a maximum of 75 grams and then drawing another sample two hours after the person begins to consume the glucose solution.
If any of these results is abnormal, the test is repeated on another day. If the repeat result is also abnormal, a diagnosis of diabetes is made.
KidsHealth.org: Kids – Diabetes Center
American Diabetes Association
Sources Used in Current Review (last reviewed 9/18/17)
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