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Prediabetes in children and adolescents: what do we need to know?

Kyungmi Jang1, Philip S Zeitler2

  • 1Department of Pediatrics, Kyungpook University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.

Annals of Pediatric Endocrinology & Metabolism
|July 8, 2026
PubMed

Insights

Pediatric obesity increases abnormal glucose metabolism risks. Lifestyle changes are key for youth prediabetes, as adult criteria and medications are often unsuitable.

Area of Science:

  • Endocrinology
  • Metabolic Health
  • Pediatric Health

Background:

  • Pediatric obesity is a global concern, linked to abnormal glucose metabolism (dysglycemia, prediabetes, type 2 diabetes).
  • These conditions correlate with cardiovascular risks like dyslipidemia, hypertension, and liver disease.
  • Insulin resistance, exacerbated by puberty, is central to pediatric metabolic dysfunction.

Purpose of the Study:

  • To review definitions, risk factors, and screening for pediatric prediabetes.
  • To discuss management strategies for prediabetes in children and adolescents.
  • To highlight challenges in applying adult diagnostic criteria to youth.

Main Methods:

  • Literature review of pediatric obesity and glucose metabolism.
  • Analysis of current screening and diagnostic guidelines for youth.
  • Evaluation of management approaches, including lifestyle modifications and pharmacotherapy.

Main Results:

  • Prediabetes in youth is complex due to physiological insulin sensitivity changes post-puberty.
  • General screening for diabetes in children is not recommended, except in high-prevalence groups.
  • Lifestyle modification is the primary intervention for identified prediabetes in youth.

Conclusions:

  • Current adult diagnostic criteria for prediabetes may not be directly applicable to pediatric populations.
  • Effective management of pediatric prediabetes relies on lifestyle interventions.
  • Further research is needed to refine diagnostic and therapeutic strategies for youth.

Keywords:
DysglycemiaInsulin resistancePediatric obesityPubertyType 2 diabetes mellitus

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