Opinion Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Dec 9, 2023; 12(5): 263-272
Published online Dec 9, 2023. doi: 10.5409/wjcp.v12.i5.263
Prediabetes in children and adolescents: An updated review
Hak Yung Ng, Louis Tsz Wang Chan
Hak Yung Ng, Louis Tsz Wang Chan, Department of Paediatrics and Adolescent Medicine, Tseung Kwan O Hospital, Hong Kong, China
Author contributions: Ng HY reviewed the literature, wrote the manuscript, revised it and approved the final version; Chan LTW reviewed the literature, revised it and approved the final version.
Conflict-of-interest statement: All the authors report no conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hak Yung Ng, MBChB, DCH, PgDipPD, MSc, FHKCPaed, FHKAM, FRCP, FRCPCH, Department of Paediatrics and Adolescent Medicine, Tseung Kwan O Hospital, No. 2 Po Ning Lane, Hang Hau, Tseung Kwan O, Hong Kong, China. nghypatrick@gmail.com
Received: July 25, 2023
Peer-review started: July 25, 2023
First decision: August 31, 2023
Revised: October 5, 2023
Accepted: October 16, 2023
Article in press: October 16, 2023
Published online: December 9, 2023
Abstract

Prediabetes, the precursor of type 2 diabetes mellitus, is an intermediate stage between normal glucose homeostasis and overt diabetes. This asymptomatic metabolic state is increasingly prevalent in pediatric population and is very difficult to detect without appropriate screening. Studies have shown that a certain proportion of children with prediabetes will develop diabetes in a few years. Even more alarming is the evidence that youth-onset diabetes has a more aggressive clinical course with progressive beta-cell decline and accelerated end-organ damage. Despite its importance, several aspects involving prediabetes in childhood are disputed or unknown. This review presents the latest insights into this challenging entity and outlines a simplified screening approach to aid clinical practice. In summary, childhood prediabetes is an important clinical condition indicating the need for proper screening and timely intervention.

Keywords: Prediabetes, Screening, Diagnosis, Management, Obesity, Type 2 diabetes mellitus, Children

Core Tip: Prediabetes, an intermediate stage before type 2 diabetes mellitus, has increased in parallel with the growing burden of pediatric obesity worldwide. However, child health practitioners are struggling with the definition, significance, diagnostic approach, trajectories, implications, outcomes, and management of prediabetes. This review aims to provide pediatricians and primary care providers with an updated overview of this important, yet controversial, condition.