Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents

Jonas, Daniel E; Schaaf, Emily B. Vander; Riley, Sean; Allison, Bianca A.; Middleton, Jennifer Cook; Baker, Claire; Ali, Rania; Voisin, C; LeBlanc, Erin S.

doi:10.1001/jama.2022.7957

Cited by 18 publications

(32 citation statements)

References 31 publications

(68 reference statements)

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“…The definitions of prediabetes and diabetes in children and adolescents are the same as in adults . A fasting plasma glucose level of 100 to 125 mg/dL (5.6-6.9 mmol/L), an HbA 1c level of 5.7% to 6.4%, or a 2-hour postload glucose level of 140 to 199 mg/dL (7.8-11.0 mmol/L) are consistent with prediabetes .…”

Section: Practice Considerationsmentioning

confidence: 99%

“…Although there is insufficient evidence to recommend for or against screening in patients without signs or symptoms, prediabetes and type 2 diabetes can be detected by measuring fasting plasma glucose or HbA1c level, or with an oral glucose tolerance test . HbA 1c level is a measure of long-term blood glucose concentration and is not affected by acute changes in glucose levels.…”

Section: Practice Considerationsmentioning

confidence: 99%

“…Formal programs to improve diet and increase exercise are often paired with pharmacotherapy . The US Food and Drug Administration has approved 3 drugs for treatment of type 2 diabetes in children: metformin, insulin, and liraglutide . While metformin has demonstrated improvements in body mass index (BMI), fasting glucose level, and insulin resistance, it is not approved by the US Food and Drug Administration to prevent the progression of prediabetes to diabetes …”

Section: Practice Considerationsmentioning

confidence: 99%

“…Obesity and excess adipose tissue, especially when centrally distributed, are the most important risk factors for type 2 diabetes in younger persons . Family history of diabetes (including gestational diabetes) is also a strong risk factor .…”

Section: Practice Considerationsmentioning

confidence: 99%

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Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents

Mangione

Barry

Nicholson

et al. 2022

JAMA

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ImportanceThe Centers for Disease Control and Prevention estimates that 210 000 children and adolescents younger than 20 years had diabetes as of 2018; of these, approximately 23 000 had type 2 diabetes. 1 Youth with type 2 diabetes have an increased prevalence of associated chronic comorbid conditions, including hypertension, dyslipidemia, and nonalcoholic fatty liver disease. 2 Data indicate that the incidence of type 2 diabetes is rising; from 2002-2003 to 2014-2015, incidence increased from 9.0 cases per 100 000 children and adolescents to 13.8 cases per 100 000 children and adolescents. 3 Most of the increase in the incidence rate is in American Indian/Alaska Native, Black, and Hispanic/Latino children and adolescents. 3 Approximately 18% of adolescents aged 12 to 18 years had prediabetes during 2005 to 2016. 4 IMPORTANCE The Centers for Disease Control and Prevention estimates that 210 000 children and adolescents younger than 20 years had diabetes as of 2018; of these, approximately 23 000 had type 2 diabetes. Youth with type 2 diabetes have an increased prevalence of associated chronic comorbid conditions, including hypertension, dyslipidemia, and nonalcoholic fatty liver disease. Data indicate that the incidence of type 2 diabetes is rising; from 2002-2003 to 2014-2015, incidence increased from 9.0 cases per 100 000 children and adolescents to 13.8 cases per 100 000 children and adolescents. OBJECTIVEThe US Preventive Services Task Force (USPSTF) commissioned a review of the evidence on screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant persons younger than 18 years. This is a new recommendation.POPULATION Children and adolescents younger than 18 years without known diabetes or prediabetes or symptoms of diabetes or prediabetes. EVIDENCE ASSESSMENTThe USPSTF concludes that the evidence is insufficient to assess the balance of benefits and harms of screening for type 2 diabetes in children and adolescents. There is a lack of evidence on the effect of screening for, and early detection and treatment of, type 2 diabetes on health outcomes in youth, and the balance of benefits and harms cannot be determined.RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for type 2 diabetes in children and adolescents. (I statement)

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Section: Practice Considerationsmentioning

confidence: 99%

Section: Practice Considerationsmentioning

confidence: 99%

Section: Practice Considerationsmentioning

confidence: 99%

Section: Practice Considerationsmentioning

confidence: 99%

See 2 more Smart Citations

Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents

Mangione

Barry

Nicholson

et al. 2022

JAMA

View full text Add to dashboard Cite

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“…In this issue of JAMA , the US Preventive Services Task Force (USPSTF) addresses this important issue with a new Recommendation Statement on screening for prediabetes and type 2 diabetes in children and adolescents based on an Evidence Report and Systematic Review of the evidence on screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant persons younger than 18 years. The Evidence Report examined several key questions that addressed the following topics: Is there direct evidence that screening for prediabetes and type 2 diabetes in asymptomatic children and adolescents improves health outcomes?…”

mentioning

confidence: 99%

Recommendations for Screening Children and Adolescents for Prediabetes and Type 2 Diabetes

Isganaitis

Laffel

2022

JAMA

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Broader Screening for Youth-Onset Type 2 Diabetes—We Just Are Not There Yet

2022

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Prior to the 1990s, almost all childhood-onset diabetes could be attributed to insulin-dependent type 1 diabetes. However, as the prevalence of obesity has increased across the US, so has the number of children and adolescents diagnosed with youth-onset type 2 diabetes. Recent US data suggest that the prevalence of type 2 diabetes in youth has increased 2-fold between 2001 and 2017. 1 The Centers for Disease Control and Prevention reported that between 2005 and 2016, 1 in 5 teens in the US had prediabetes, 2 defined as blood glucose levels that are higher than reference range but do not meet criteria for diabetes. A further spike in the incidence of youth-onset type 2 diabetes has occurred during the COVID-19 pandemic. 3 Given the increasing rates of prediabetes and youth-onset type 2 diabetes and associated comorbidity, the US Preventive Services Task Force (USPSTF) assessed whether there is evidence to support screening asymptomatic children and adolescents for type 2 diabetes. 4,5 The USPSTF concluded that there is "insufficient evidence to assess the balance of benefits and harms of screening for prediabetes and type 2 diabetes in youth" (I statement). 4,5 This was owing to a dearth

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Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents

Cited by 18 publications

References 31 publications

Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents

Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents

Recommendations for Screening Children and Adolescents for Prediabetes and Type 2 Diabetes

Broader Screening for Youth-Onset Type 2 Diabetes—We Just Are Not There Yet

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