More than 1 in 4 adolescents have prediabetes, a condition where blood sugar is elevated but not yet in the diabetes range. These blood-sugar-friendly lifestyle changes can benefit the whole family.
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Here's a shocking statistic: More than 1 in 4 preteens and teens in the U.S. have prediabetes, a number that more than doubled in two decades, according to a study published in March 2022 in JAMA Pediatrics. The study found that 28% of adolescents ages 12 to 19 were diagnosed with diabetes in 2018, compared to 12% in 1999. This data is similar to adults, as 1 in 3 American adults have prediabetes, according to the latest data from the Centers for Disease Control and Prevention.

What Is Prediabetes?

Prediabetes is often a silent health condition. "Prediabetes means that your blood sugar levels are higher than normal, but not high enough for you to be diagnosed with type 2 diabetes," explains certified diabetes care and education specialist Diana Licalzi, RD, the co-founder of Reversing T2D in Boulder, Colorado. While there are often few, if any, noticeable symptoms of prediabetes for patients, many people will go on to develop type 2 diabetes within five years if they don't take steps to treat their prediabetes, she says. "Changing your diet and lifestyle can significantly reduce your risk," she adds.

New Research in Prediabetes

In the JAMA Pediatrics study, researchers analyzed data from 6,600 12- to 19-year-olds who took part in the biennial National Health and Nutrition Examination Survey. Scientists focused on a hemoglobin A1C numbers, aka HbA1c, a measure of blood sugar levels over a three-month span.

A1C numbers are used to diagnose prediabetes in adolescents and adults, says Licalzi.

  • Normal: < 5.7%
  • Prediabetes: 5.7% to 6.4%
  • Diabetes: > 6.4%

A fasting blood glucose score is another way doctors might test for type 2 diabetes; 100 to 125 mg/dL is considered prediabetes, anything higher is type 2.

Looking at the rates of prediabetes over time allowed the scientists to chart general trends. They found that prediabetes was most prevalent in males ages 12 to 18. Kids who have the following risk factors are more likely to develop diabetes, according to the CDC:

  • Are at a weight that's considered overweight
  • Are physically inactive
  • Have a family member who has type 2 diabetes
  • Are African American, Hispanic/Latino, Native American/Alaska Native, Asian American or Pacific Islander
  • Have a mother who had gestational diabetes (diabetes when pregnant)

This research finding isn't entirely surprising, say experts. "Trends show that less than 1 in 4 of all children between ages 6 and 17 participate in 60 minutes of physical activity every day, which is the recommended amount of activity for this age group, according to the CDC," says Lauren Manaker M.S., RD, LD, a registered dietitian and owner of Nutrition Now Counseling in Charleston, South Carolina. "And 1 in 5 adolescent children have obesity. As risk factors for prediabetes increase, it makes sense that the prevalence of prediabetes increases as well," she says.

teens eating fast food
Credit: Getty Images / mediaphotos

5 Dietitian Tips for Parents of Kids Who Are At-Risk for (Or Have Been Diagnosed with) Prediabetes

Parents can help their children get healthy and reverse prediabetes. "If nothing is done to intervene, these adolescents are at much higher risk for developing type 2 diabetes and its long-term complications, including heart disease, stroke, kidney failure and blindness," says Licalzi. Here are five lifestyle recommendations that can make a big difference.

1. Get moving

Aim for 60 minutes every day. While that can happen if your child participates in organized sports, they don't have to join a team, Manaker says. "For younger kids, visit a playground to encourage some movement. Go for a walk after dinner or play a family game of freeze tag. Anything to get the kids off of the couch and get their blood flowing can help," she recommends.

2. Skip soda and other sugar-sweetened beverages

Soda and fruit drinks that look like juice (but aren't) are staples in many kids' diets. The CDC reports that 63% of youth drink at least one sugar-sweetened drink daily. These can be considered "empty calories," according to Licalzi, meaning they contribute calories without any nutritional benefits. Opt for water—sparkling or still or 100% fruit juice—for proper hydration instead. If they're craving more flavor, try adding citrus.

3. Add more produce

Vegetables in particular are a wise choice, since they're "packed with fiber, are low in calories and are chock-full of micronutrients that can help support overall health," Manaker says. Veggies are in short supply among many kiddos' menus: A 2021 CDC survey found that just 2% of teens eat enough. "Instead of taking away too many foods to reduce prediabetes risk, try adding foods like veggies to their dishes they already love to encourage them to eat more of these good-for-you foods," she recommends. Try Skillet Mac and Cheese with Zucchini and Pimiento, Rainbow Veggie Pizza, and Sweet Potato Shepherd's Pie.

4. Cook together

It's a great way to bond and get them excited about healthy eating. "This is one of the best ways to teach kids about nutritious foods and gives them the confidence to prepare their own meals," Licalzi says. Score bonus points by shopping for the ingredients or even growing fruits and vegetables together so your little ones feel invested in every step of the process.

5. Avoid strict elimination diets

Cutting out carbs or embarking on a sugar "detox" will not do you or your child any favors, Manaker says. "Restriction can lead to binge eating, which is something that, over time, can cause much more harm than good when it comes to your child's health," she says.

Rather than making certain foods totally off-limits, try to reposition them as "sometimes foods" versus "always foods." "If you are limiting anything, be sure to have something delicious to offer in its place that's a more nutritious yet still tasty choice," Manaker says. For example, instead of a popsicle after dinner, share a big bowl of frozen grapes.

The Bottom Line

A prediabetes diagnosis isn't reason to panic, but it can—and should—act as a strong reminder to focus on making healthy lifestyle choices as a family, Licalzi says. Certain changes can make a big difference, like cooking together, fueling up with a colorful, whole foods-focused diet and staying active together as a family.