Looking for better tests to identify kids with Prediabetes and Type 2 Diabetes

Finding better diabetes testsAs a pediatric endocrinologist, I see many overweight or obese children who are referred for evaluation of prediabetes or type 2 diabetes.

You may be asking, what is type 2 diabetes? It’s the type of diabetes that is associated with carrying excess weight. Only adults used to develop type 2 diabetes, but now unfortunately more and more kids are getting the disease as well.

And what is prediabetes? It’s a condition where individuals don’t have high enough blood glucose levels to be classified as having diabetes, but have a much higher risk of developing type 2 diabetes in the future compared with other kids.

Pediatricians often refer overweight and obese kids to specialists like me for evaluation of these conditions, but they all don’t necessarily need to see us. The problem is that it’s currently hard to distinguish a child with a high BMI who is at risk for developing diabetes from one who is not; if we knew which tests could best identify kids with prediabetes and diabetes, we could save some patients the step of seeing a pediatric endocrinologist, and get the ones who DO need to see a specialist in for an appointment sooner. The challenge is all about getting the right kids to a specialist at the right time, thereby making our healthcare delivery system more efficient and providing better care to those who need it.

As with many diseases, we know much more about tests for prediabetes and type 2 diabetes screening in adults than in children. That’s why I am embarking on a new research project that recently received a $1.7-million grant from the National Institutes of Health to help identify biomarkers that can predict prediabetes and type 2 diabetes in kids. Testing for diabetes and prediabetes has traditionally involved testing for the biomarker Hemoglobin A1c (HbA1c). However, test results for HbA1c are different in children than adults. We need to further study these biomarkers and other newer biomarkers in children to determine which tests are best for identifying children at risk for prediabetes or type 2 diabetes. Children are not just little adults, and we need clinical studies specifically focused on them to help improve their health and the healthcare we provide them.

Among obese and overweight children in the U.S., rates of diabetes and prediabetes can be as high as 30 percent. Those with prediabetes in childhood are more likely to develop Type 2 diabetes as adolescents or young adults. Identifying those children early is critical for helping them make lifestyle changes that will improve their long-term health, hopefully preventing them from developing diabetes. Even if we can’t prevent it completely, we hope to delay its onset for as long as possible. The longer a person has diabetes, the more of a toll it takes on his body, so every year we can prevent the development of diabetes is tremendously beneficial to that person’s life. This research will to be underway for about the next 3-4 years, but once we have our findings, we hope that it will impact how we manage and deliver care to kids in the future.

Take the next steps:

Joyce Lee MDJoyce Lee, MD, MPH, is a pediatric endocrinologist with C.S. Mott Children’s Hospital. She graduated from the University of Pennsylvania School of Medicine and completed her residency in pediatrics at Children’s Hospital in Boston. She completed a fellowship in pediatric endocrinology at C.S. Mott Children’s Hospital. Dr. Lee sees patients at C.S. Mott Children’s Hospital.


best children's hospitalsUniversity of Michigan C.S. Mott Children’s Hospital is consistently ranked one of the best hospitals in the country. It was nationally ranked in all ten pediatric specialties in U.S. News Media Group’s “America’s Best Children’s Hospitals,” and among the 10 best children’s hospitals in the nation by Parents Magazine. In December 2011, the hospital opened our new 12-story, state-of-the-art facility offering cutting-edge specialty services for newborns, children and women.