Prediabetes: the silent danger facing U.S. teens

Prediabetes is a condition in which your blood glucose, or blood sugar, is elevated but not high enough to be considered diabetes. Having prediabetes increases your risk of type 2 diabetes and other serious illnesses such as heart disease and stroke.

Research suggests the rate of prediabetes in teenagers in the United States has more than doubled since 2000. Currently, about one-third of U.S. teens have the condition.

The rates have increased among both boys and girls and in all body mass index (BMI) categories. (BMI is a screening tool for weight and body composition. It indicates if someone is underweight, of normal weight, or whether they are considered overweight or obese.) Even teens who are classified as underweight or normal weight have seen their rates of prediabetes increase.

Why are prediabetes rates rising?

The growing rates of prediabetes in teenagers are likely a reflection of certain trends over the past few decades. These include:

• Heavy consumption of processed foods, which include packaged chips, snacks, cakes, and candies
• More sedentary lifestyles, which means more sitting and less physical activity
• Increased environmental pollution
• Rising rates of obesity

Obesity is linked to prediabetes because it interferes with the body’s ability to control blood sugar. If you or your kids are overweight, ask your family healthcare provider (HCP) about being tested for diabetes at your next appointment.

What are other diabetes risk factors to know about?

There are several other factors that may indicate a need to get your teen tested for diabetes. These include:

• A family history of diabetes
• Having other risk factors for heart disease, like high cholesterol or high blood pressure
• An inactive lifestyle
• Having polyendocrine metabolic ovarian syndrome (PMOS), a condition previously known as polycystic ovary syndrome (PCOS). PMOS usually begins around puberty and involves hormone levels that are out of balance and irregular menstrual periods.
• Having acanthosis nigricans, or dark, sometimes velvety patches of skin around the neck, groin, and/or armpits caused by greater amounts of insulin in the blood. (Insulin is a hormone that helps regulate blood sugar levels.)

What can I do if my teen has prediabetes?

The good news about prediabetes in teens—or having prediabetes at any age—is that it’s possible to reverse the condition and greatly lower the risk of developing type 2 diabetes. Making certain lifestyle changes can help get your blood sugar under control. These include:

Get moving

Teenagers should get 60 minutes of moderate- to vigorous-intensity exercise every day. That means running, hiking, biking, or playing team sports like basketball or soccer. It can also include intensive chores, like vacuuming and washing windows. It's also important that teens do muscle-building activities at least three days per week. That may involve weight lifting or doing body-weight exercises like push-ups.

Teens should also reduce their time spent sitting down, especially in front of screens (like TVs, computers, tablets, or smartphones).

Make small diet changes that’ll add up over time

It can help to work with an HCP or a dietitian to create a diet plan to lower your risk of diabetes and heart disease. Some smart steps to improve diet include the following:

• Limit sugary soda and fruit juice. Encourage plain water instead.
• Significantly reduce intake of packaged, processed foods.
• Eat plenty of whole fruits and vegetables throughout the day.
• Plan meals, shop for food, and cook together regularly.
• Help your kids to self-regulate the amount they eat by paying attention to their eating during meals instead of eating in front of screens.
• Don’t demand or suggest that they “clean their plates.” Help them learn to trust their own hunger and fullness cues and stop when they feel satisfied.

In certain cases, an HCP may recommend a GLP-1 medication. Some are approved by the U.S. Food and Drug Administration for managing weight in adolescents.

Teach them about the dangers of smoking

Smoking increases your risk of diabetes and other life-threatening conditions like lung cancer and COPD. Help your teens avoid secondhand smoke and stop (or never start) vaping.

What resources can help me manage my teen’s prediabetes?

If you or your teen has prediabetes and you’re trying to reverse it, don’t go it alone. There are people and resources available to help in addition to your HCP. Consider reaching out to one of these resources when creating your diabetes prevention plan:

• The Centers for Disease Control and Prevention (CDC) offers lifestyle change programs in towns across the country. Programs include healthy cooking classes, information sessions on diabetes, and opportunities to work with trained lifestyle coaches.
• Your local YMCA may also offer diabetes prevention programs, along with exercise classes and personal training sessions.

Prediabetes doesn’t always have symptoms, so if you’re concerned, ask your HCP for a screening test. Learning your results sooner rather than later can put you on track toward a healthier lifestyle—and preventing a type 2 diabetes diagnosis in the future.