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USPSTF and ISPAD Guidelines on Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents
Aaradhana Singh1, Aashima Dabas2
1Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi.
Insights
Childhood obesity is a growing concern, increasing the risk of type 2 diabetes. Guidelines now recommend targeted screening for at-risk youth, focusing on early detection and management of pediatric diabetes.
Area of Science:
- Pediatrics
- Endocrinology
- Public Health
Background:
- Rising global trends in obesity and metabolic syndrome contribute to adult non-communicable diseases, with origins in childhood.
- Type 2 diabetes is a significant contributor to the childhood non-communicable disease burden.
- Obesity and insulin resistance are key risk factors for developing type 2 diabetes in youth.
Purpose of the Study:
- To summarize recent guidelines on screening for youth-onset prediabetes and type 2 diabetes.
- To highlight the importance of identifying at-risk children for early intervention.
- To provide updated information on diagnostic criteria for pediatric diabetes.
Main Methods:
- Review of recent guidelines from the US Preventive Services Task Force (USPSTF) and the International Society for Pediatric and Adolescent Diabetes (ISPAD).
- Analysis of diagnostic criteria for prediabetes and diabetes based on fasting plasma glucose levels.
- Focus on targeted screening recommendations for specific pediatric populations.
Main Results:
- Guidelines suggest targeted screening for youth-onset type 2 diabetes in at-risk children (e.g., obese, family history).
- The role of screening asymptomatic children for type 2 diabetes is not yet substantiated.
- Diagnostic cutoffs for prediabetes are fasting plasma glucose >100 to 125 mg/dL, and for diabetes are ≥126 mg/dL.
Conclusions:
- Early identification of prediabetes and type 2 diabetes in children is crucial due to rising trends.
- Targeted screening in at-risk youth is recommended, aligning with recent expert guidelines.
- Further research may be needed to establish the role of screening in asymptomatic children.
Abstract:
The rising trends of obesity, metabolic syndrome and diabetes in adults are worrisome globally. The majority of antecedents to adult non-communicable diseases begin in childhood. Type 2 diabetes is recognized as one of the major diseases that contribute to the NCD burden in childhood. Recently, the US Preventive Services Task Force (USPSTF) and the International Society for Pediatric and Adolescent Diabetes (ISPAD) released their guidelines on diagnosis and management of prediabetes and diabetes in children targeted screening for youth-onset type 2 diabetes is suggested in at-risk children (obese, positive family history of type 2 diabetes, etc.), while the role of screening asymptomatic children is not substantiated. Obesity and insulin resistance are important risk factors for type 2 diabetes. The cutoffs of fasting plasma glucose for the diagnosis of prediabetes and diabetes are >100 to 125 and ≥126 mg/dL, respectively. This update briefly summarizes the recommendations on screening for youth-onset prediabetes and type 2 diabetes.
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