Written by Diana Licalzi, MS, RD

A study published in JAMA found the rates of prediabetes among adolescents 12 to 19 have doubled in the past 20 years!

According to Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City, type 2 diabetes used to be uncommon in people under the age of 65, but has gradually become more prevalent in younger age groups. Dr. Zonszein stated that there is now a high incidence of prediabetes in younger people, and that when they do develop type 2 diabetes, it tends to be more aggressive and less responsive to lifestyle changes compared to older individuals with diabetes.

In this blog, we’ll dive into prediabetes, what it means to have prediabetes as a teen, why prediabetes rates in adolescents are climbing rapidly, and ways parents can help reduce their teen’s risk for prediabetes.

Is prediabetes in teens different from prediabetes among adults?

Prediabetes is when blood sugar levels are higher than normal, but not high enough for a type 2 diabetes diagnosis. While the general definition of prediabetes is the same for teens and adults, there are some differences in how the condition can affect younger individuals.

One key difference is that prediabetes in teens and young adults is often associated with higher rates of obesity and other metabolic disorders, such as high blood pressure and high cholesterol. This can make it more difficult to manage blood sugar levels and increase the risk of developing type 2 diabetes at a young age.

In addition, some studies suggest that prediabetes in teens may progress to type 2 diabetes more quickly than in adults, with a higher likelihood of developing complications associated with diabetes, such as nerve damage and kidney disease.[2-4]

Why are prediabetes rates in adolescents climbing so rapidly?

There are several factors that may be contributing to the rapid increase in prediabetes rates among adolescents. 

• Obesity: The rise in obesity rates among young people is a major contributor to the increase in prediabetes. Obesity is a significant risk factor for insulin resistance, which can lead to prediabetes and type 2 diabetes.
• Sedentary lifestyle: Many adolescents today are more sedentary than in previous generations, with more time spent on electronic devices and less time engaging in physical activity. This lack of activity can contribute to weight gain and insulin resistance.
• Unhealthy diet: The high consumption of processed and fast foods, sugary drinks, and snacks is another major factor that contributes to the rise in prediabetes rates among adolescents. These types of foods are often high in calories, sugar, and unhealthy fats, which can contribute to weight gain and insulin resistance.
• Genetics: Some adolescents may be more predisposed to developing prediabetes and type 2 diabetes due to genetic factors.
• Other medical conditions: Certain medical conditions, such as polycystic ovary syndrome (PCOS), can also increase the risk of developing prediabetes and type 2 diabetes.

It's important to note that these factors do not act in isolation and can interact with each other in complex ways, making it difficult to address the problem of rising prediabetes rates among adolescents. However, lifestyle changes such as a healthy diet and regular exercise can help to prevent or manage prediabetes, even in young people.

Should I screen my teen for prediabetes?

Prediabetes screening, while standard for adults, is only recommended for overweight children with certain other risk factors. But screening for teens is important because prediabetes is not always accompanied by symptoms. As a result, many people will not realize that they have the condition until it has already progressed to type 2 diabetes. 

It is a good idea to consider screening your teen for prediabetes, especially if they have risk factors such as being overweight or obese, having a family history of type 2 diabetes, or having other medical conditions such as polycystic ovary syndrome (PCOS). Screening for teens is important because prediabetes is not always accompanied by symptoms.

Screening for prediabetes involves a simple blood test that measures fasting blood glucose levels or a hemoglobin A1C test, which measures blood glucose levels over the past 2-3 months. The American Diabetes Association recommends screening for prediabetes in overweight or obese individuals who have additional risk factors starting at age 10, and in all individuals starting at age 45.

If your teen is found to have prediabetes, it's important to work with a healthcare professional to develop a plan to manage the condition through lifestyle changes such as healthy eating, regular physical activity, and weight management. In some cases, medication may also be prescribed to help manage blood sugar levels. By managing prediabetes early on, you can help reduce the risk of developing type 2 diabetes and improve overall health outcomes.

7 ways parents can help reduce their adolescent's risk for prediabetes

 If you are the parent of a child with a high risk for prediabetes, consider taking these seven action steps:

1. Reduce sugar intake especially sugary sweetened beverages, which add excess calories without any nutritional value.
2. Find ways for your teens to increase their physical activity: workout more as a family, go on a family hike, or help find sports that your child finds interesting. 
3. Bring your adolescents into the kitchen. This is one of the best ways to teach them about foods and gives them the confidence to prepare their own meals. 
4. Cut down on highly processed food and fast food. Instead, choose healthy foods such as fresh fruits and vegetables. Minimize servings of red meat, and increase servings of fish, legumes, whole grains, and lean meat.
5. Reduce screen time: televisions, phones, tablets, and computers.
6. Get a good night’s sleep. Insufficient or fitful sleep through the night may lead to insulin resistance and high blood glucose (blood sugar) levels, raising your risk for diabetes. Aim to get seven to eight hours of quality sleep each night.
7. Manage stress. When you worry or are anxious, you are more likely to snack more, exercise less and make other unhealthy choices. Such stress may lead to elevated blood glucose levels.

As a parent, what is the best way to handle sensitive diet and food topics with adolescents?

As a parent, it can be challenging to navigate sensitive diet and food topics with adolescents, but there are several strategies you can use to promote healthy eating habits without causing unnecessary stress or anxiety:

• Model healthy behaviors: Adolescents often model their behavior after their parents and caregivers, so it's important to set a good example by practicing healthy eating habits yourself. This can include eating a variety of fruits and vegetables, choosing whole grains and lean proteins, and avoiding highly processed or sugary foods.
• Encourage open communication: Create a safe and supportive environment where your adolescent feels comfortable talking about their concerns and questions related to food and diet. Avoid judgment or criticism and instead, listen to their perspective and offer guidance when appropriate.
• Focus on positive messaging: Instead of framing food and diet in terms of restriction or deprivation, focus on positive messaging that emphasizes the importance of eating a variety of healthy foods to support overall health and well-being.
• Involve your adolescent in meal planning and preparation: Giving your adolescent a role in meal planning and preparation can help them feel more invested in healthy eating habits and provide opportunities to learn new skills and try new foods.
• Seek professional help if needed: If your adolescent is struggling with a specific dietary issue or eating disorder, seek the help of a healthcare professional who can provide specialized support and guidance.

Overall, the key is to approach sensitive diet and food topics with empathy and understanding, and to promote healthy eating habits as a positive and rewarding aspect of overall health and well-being.

References

[1] https://jamanetwork.com/journals/jamapediatrics/fullarticle/2790364 

[2] Zeitler P, Hirst K, Pyle L, et al. A clinical trial to maintain glycemic control in youth with type 2 diabetes. N Engl J Med. 2012;366(24):2247-2256. 

[3] Bacha F, Gungor N, Lee S, Arslanian SA. Progressive deterioration of β-cell function in obese youth with type 2 diabetes. Pediatr Diabetes. 2017;18(8):722-729.

[4] Nadeau KJ, Anderson BJ, Berg EG, et al. Youth-onset type 2 diabetes consensus report: current status, challenges, and priorities. Diabetes Care. 2016;39(9):1635-1642.