Prediabetes in youths: mechanisms and biomarkers

Abstract

Obesity has been estimated to decrease life expectancy by as little as 0.8 to as much as 7 years being the second leading cause of preventable death in the United States after smoking. Along with the increase in the prevalence of obesity, there has been a dramatic rise of the prevalence of prediabetes and type 2 diabetes among adolescents. Despite that, very little is known about the pathogenesis of these conditions in pediatrics and about how we could detect prediabetes in an early stage in order to prevent full blown diabetes. In this review we summarize the current knowledge on the pathophysiology of prediabetes and type 2 diabetes in adolescents and describe how biomarkers of beta-cell function might help identifying those individuals who are prone to progress from normal glucose tolerance towards prediabetes and overt type 2 diabetes. To better understand and fight this disease, we will need to explore and develop novel therapeutic strategies and individuate more sensitive and specific biomarkers that can allow an earlier detection of the disease.

Associations of adiposity and parental diabetes with prediabetes among adolescents in Kuwait: A cross‐sectional study

“…Prediabetes prevalence decreased as age increased. This observation is supported by previous studies, which showed that insulin resistance increases during puberty and rests to per‐pubertal rates after puberty . The increase in insulin resistance during puberty has been shown to be associated with increased prevalence of prediabetes .…”

“…Prediabetes (intermediate hyperglycemia), a high‐risk state for developing diabetes, is characterized by blood glucose levels that are above the normal but lower than the diabetes diagnostic thresholds . The altered glucose metabolism found in prediabetes can be described as impaired fasting glucose (IFG), impaired glucose tolerance (IGT), elevated glycated hemoglobin A1c (HbA1c), or their combinations . Although these conditions may refer to a distinct pathophysiological states, their abnormalities, in childhood or adulthood, confer increased risk for developing type 2 diabetes mellitus (T2DM) as well as microvascular and macrovascular diseases …”

“…Historically, T2DM has been viewed as a disease of later adulthood; however, in recent decades this perspective has changed as prediabetes and T2DM have become more prevalent among children and adolescents . This shift in diabetes paradigm, at least among youth is contaminant with the ever increasing prevalence of overweight and obesity . Previous reports showed that prediabetes prevalence varies widely across populations; for instance, prediabetes can affect up to 45% of obese children and adolescents .…”

“…This shift in diabetes paradigm, at least among youth is contaminant with the ever increasing prevalence of overweight and obesity . Previous reports showed that prediabetes prevalence varies widely across populations; for instance, prediabetes can affect up to 45% of obese children and adolescents . In regard to time trends, the prevalence of prediabetes among US adolescents aged 12 to 17 years has increased from 13.3% in 1999‐2002 to 17.9% in 2007‐2010 .…”

Cardiovascular risk factors in adolescents with prediabetes

“…Previous literature has shown that the prevalence in the USA was 2–9% based on the WHO criteria and 15–47% based on the ADA criteria [21]. These estimates align with our results; in subgroup analysis we found that the prevalence of prediabetes ranged from 13.3% among females to 24.4% among those who were obese.…”