No Need To Screen For Type 2 Diabetes In Kids And Youth, Says USPSTF

March 4, 2023

Childhood obesity is pretty common. Thus, children are increasingly showing signs of metabolic disorders. The incidence of type 2 diabetes has also been rising in children and youth. Thus, the question arises if it is good to regularly screen all children and youth for type 2 diabetes since early identification and treatment of the condition are associated with better outcomes. However, a systemic review commissioned by USPSTF shows that screening for type 2 diabetes is only justified in high-risk children, and mass screening for the condition is not justified.

First and foremost, let us be clear that US Preventive Services Task Force (USPSTF) recommendations are for type 2 diabetes, which is generally diagnosed in obese adults. Unlike type 1 diabetes, which is mainly diagnosed in kids and adolescents. About 90% of all those living with diabetes in the US are living with type 2 diabetes. It is a condition caused by insulin resistance and is a lifestyle disorder. It takes years to develop in most cases. It means that it is rarely diagnosed in kids or youth. However, it is pretty common in older adults, affecting more than 10% of the population.

Kids are more likely to be affected by an autoimmune condition called type 1 diabetes, in which immune cells destroy insulin producing beta cells in the pancreas. At present, there are about 210,000 kids living with diabetes, but most of them are living with type 1 diabetes. However, the issue is that type 2 diabetes is also increasing in kids due to higher obesity rates and the prevalence of the metabolic disorder.

Thus, out of 210,000 kids living with diabetes, about 23,000 have type 2 diabetes. These numbers are not massive but significant. This raises one important question, should doctors regularly screen kids and youth for type 2 diabetes? Especially considering that metabolic disorders like dyslipidemia, non-alcoholic fatty acid liver disease, and even hypertension are on the rise in children and young adults. Moreover, the covid-19 pandemic has further magnified the trend.

For families dealing with diabetic neuropathy, it is important to seek out specialized treatment options. There are a number of healthcare providers and clinics that specialize in diabetic neuropathy treatment, including nerve conduction studies, pain management, and physical therapy. Effective treatment for diabetic neuropathy can help manage symptoms and prevent further damage to the nerves. If you or a loved one are dealing with diabetic neuropathy, it is important to reach out to a qualified healthcare provider to discuss treatment options and find the right solution for your needs.

Additionally, type 2 diabetes in the young is more harmful to health. It is more likely to progress fast, causing chronic health complications like cardiovascular issues, chronic kidney disease, and so on. However, the latest study by USPSTF says that there is no need for regular screening for type 2 diabetes in kids and youth, as distress caused by such a kind of screening cannot be still justified. In 2022, USPSTF commissioned a systemic review to understand the harm and benefits of such screening. They wanted to understand if regular screening for type 2 diabetes is justified in kids or youth who do not have many symptoms.

They concluded that any such screening should only be done in high-risk kids and youth, like those with some symptoms and grossly overweight. However, there is no reason for mass screening for type 2 diabetes in this young population, as it will do more harm than good. The study also made other recommendations related to the early diagnosis and management of the condition. For example, though there are more than 30 drugs to treat type 2 diabetes, only three are approved for use in children: metformin, insulin, and liraglutide.

Among these drugs, metformin is good for managing the diabetes of the young. However, it is not approved for preventing the progression of prediabetes to diabetes in the young population. Additionally, the study also found that extensive lifestyle intervention, which is the method of choice for managing early diabetes, is less effective in children and adolescents than in adults.

Nonetheless, the study recommends that prediabetes and mild type 2 diabetes in children should be managed through weight loss, dietary measures, and enhancing physical activity. Though lifestyle interventions like weight loss are less effective in children, health experts say that it is still the safest and most effective way to reduce the progression of type 2 diabetes in children. To sum up, USPSTF says screening is only good for high-risk children like those grossly obese and showing other signs of insulin resistance like acanthosis nigricans or polycystic ovary syndrome.

By Gurpreet Singh Padda, MD, MBA, MHP