Prediabetes and Adolescence—Trends, Causes, Effects, and Screening

Abstract

I ntermediate hyperglycemia, or prediabetes, is increasing worldwide, affecting people of all ages, including adolescents. Hormonal, physiological, psychological, and lifestyle changes in adolescence have been associated with disruptions in glucose homeostasis, such as decreased insulin sensitivity, insulin resistance, or the combination of both. As a rule, glucose homeostasis is ameliorated, in normal subjects, when puberty is completed. However, in susceptible individuals, like obese adolescents, or adolescents with a strong genetic background, there is a progression to type 2 diabetes onset. Thus, susceptible adolescents should be screened for prediabetes, using fasting plasma glucose, and glycated hemoglobin (HbA1c), and oral glucose tolerance testing. Prediabetic adolescents should be counseled for a healthy lifestyle including healthy dietary habits, increased physical activity, and/or stress management. Other pathological conditions should be adequately treated. Early recognition of prediabetes in adolescence will prevent type 2 diabetes onset, decreasing the diabetes-associated health burden in adult life. This review aims to revise the associations and elucidate on the gaps between prediabetes and adolescence, via a comprehensive review of the current medical literature.