Table 2.5.

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

Screening should be considered in youth* who have overweight (≥85th percentile) or obesity (≥95th percentile) A and 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 and ethnicity (e.g., 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

GDM, gestational diabetes mellitus.

^*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 or risk factor profile is deteriorating) is recommended. Reports of type 2 diabetes before age 10 years exist, and this can be considered with numerous risk factors.