Study: Most Children Eligible for Screening for Diabetes, Prediabetes Are Unlikely to Be Diagnosed as Positive

A Pediatrics study that evaluates the performance of current American Diabetes Association (ADA) screening and diagnostic criteria finds that -- while a large number of children and adolescents are eligible for screening for diabetes and prediabetes -- few will test positive. The study, “Screening and Diagnosis of Prediabetes and Diabetes in U.S. Children and Adolescents,” will be published in the September 2020 Pediatrics (published online Aug. 10). Researchers reviewed records of 14,119 youth ages 10-19 in the 1999-2016 National Health and Nutrition Examination Survey). They found that, overall, 25.5% of 10.6 million U.S. children would be eligible for screening for type 2 diabetes under the expanded criteria for screening (as opposed to 10%- or 3.6 million - under the prior eligibility criteria). The authors found that few of those screened would meet diagnostic criteria for diabetes and found that the sensitivity and specificity of the screening criteria for detecting any hyperglycemia were low. Prior to 2018, the ADA and American Academy of Pediatrics (AAP) first recommended general screening for type 2 diabetes in asymptomatic youth ages 10 and older (or after onset of puberty). Another finding from the study was evidence that HbA1c is a useful non-fasting test in children and adolescents, regardless of screening eligibility, and could be useful to identify high-risk youth who could benefit from lifestyle interventions to prevent diabetes and cardiovascular risk in adulthood.

Editor’s note: A solicited commentary, “Promoting Prevention, Identification, and Treatment of Prediabetes and Type 2 Diabetes in Youth,” is published in the same issue of Pediatrics.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.