An initial screening is recommended for children with BMI above the 85th percentile with a fasting or random blood glucose and/or HbA1c. Screening is recommended yearly or sooner if BMI is increasing or if there are symptoms of diabetes (polyuria/polydipsia, unexplained weight loss, fatigue).
Initial management includes weight management, which is crucial in the treatment of prediabetes and diabetes. Providers should encourage families to follow standards for exercise and nutrition, or refer to a nutritionist if needed.
Metformin is the first line of therapy for patients with prediabetes who fail lifestyle intervention and for those with Type 2 diabetes.