TABLE 2.4

Risk-based screening for type 2 diabetes or prediabetes in asymptomatic children and adolescents in a clinical setting

Testing should be considered in youth* with overweight (≥85th percentile) or obesity (≥95th percentile) A who have one or more additional risk factors based on the strength of their association with diabetes:
  • • Maternal history of diabetes or GDM during the child’s gestation A

  • • Family history of type 2 diabetes in first- or second-degree relative A

  • • Race/ethnicity (Native American, African American, Latino, Asian American, Pacific Islander) A

  • • Signs of insulin resistance or conditions associated with insulin resistance (acanthosis nigricans, hypertension, dyslipidemia, polycystic ovary syndrome, or small-for-gestational-age birth weight) B

  • * After the onset of puberty or after 10 years of age, whichever occurs earlier. If tests are normal, repeat testing at a minimum of 3-year intervals, or more frequently if BMI is increasing, is recommended. Reports of type 2 diabetes before age 10 years exist, and this can be considered with numerous risk factors.