Prediabetes among Obese Youth

Prediabetes is an intermediate state reflecting early abnormalities of glucose metabolism when the criteria do not fit the diagnosis of diabetes. The term is used both for children with clear type 1 diabetes who were identified very early in the disease course, have hyperglycemia and positive antibodies, but do not fulfill the criteria for diabetes, and for children with a suggestive clinical picture of pending type 2 diabetes mellitus (T2DM). This chapter focuses only on pre-T2DM. Prediabetes in children and adolescents is relatively newly identified entity that needs to be further studied in terms of efficient screening approaches, populations at risk, progression rates to frank T2DM, and treatment. However, despite the challenges in the reliability of screening tests among youth and despite the fact that clear screening and treatment guidelines are still lacking, the relatively high progression rates to diabetes and, more important, the evidence that prediabetes itself is a high-risk state for cardiovascular disease means that it will be critical to define and develop intensive evaluation and intervention strategies for these high-risk youth.