Abstract
Diabetes is a devastating public health problem. Prediabetes is an intermediate stage in the disease processes leading to diabetes, including types 1 and 2 diabetes. In the article “Prediabetes in children and adolescents: An updated review,” the authors presented current evidence. We simplify and systematically clearly present the evidence and rationale for a conceptual framework we term the ‘3ASs’: (1) Awareness Sensible; (2) Algorithm Simple; and (3) Appealing Strategies. Policy makers and the public need to be alerted. The prevalence of prediabetes should send alarm bells ringing for parents, individuals, clinicians, and policy makers. Prediabetes is defined by the following criteria: impaired fasting glucose (100-125 mg/dL); impaired glucose tolerance (2 h postprandial glucose 140-199 mg/dL); or hemoglobin A1c values of 5.7%–6.4%. Any of the above positive test alerts for intervention. Clinical guidelines do not recommend prioritizing one test over the others for evaluation. Decisions should be made on the strengths and shortfalls of each test. Patient preferences and test accessibility should be taken into consideration. An algorithm based on age, physiological stage, health status, and risk factors is provided. Primordial prevention targeting populations aims to eliminate risk factors through public education and encouraging practices through environmental modifications. Access to healthy foods is provided. Primary prevention is for individuals with a prediabetes diagnosis and involves a structured program to reduce body weight and increase physical activity along with a healthy diet. An overall methodical move to a healthy lifestyle for lifelong health is urgently needed. Early energetic prediabetes action is necessary.
Publisher
Baishideng Publishing Group Inc.
Reference21 articles.
1. American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines For Medical Care of Patients with Obesity
2. USPSTF and ISPAD Guidelines on Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents
3. Powers AC, Niswender KD, Evans-Molina C. Diabetes Mellitus: Diagnosis, Classification, and Pathophysiology In: Jameson JL, Loscalzo J, Fauci AS, Kasper DL, Hauser SL, Longo D, Jameson JL, editors. Harrison’s Principles of Internal Medicine. 21st ed. New York: McGraw Hill; 2022. p 3094-3103
4. Global prevalence of prediabetes in children and adolescents: A systematic review and meta‐analysis
5. Preface