Diagnosis and Screening of Pediatric Diabetes Mellitus

Diagnosis and screening of diabetes mellitus in children centre on timely identification of abnormal glycaemia to mitigate long-term complications. Clinical evaluation integrates measurements of fasting plasma glucose, random plasma glucose, glycated haemoglobin and oral glucose tolerance testing. In type 1 diabetes, rapid onset of hyperglycaemia and autoantibody profiling can expedite diagnosis, whereas type 2 diabetes often emerges insidiously in the context of obesity and insulin resistance. Prediabetes, defined by intermediate elevations of fasting glucose or HbA1c, signals heightened cardiovascular risk and mandates early intervention. Challenges in paediatric screening include age-related variations in insulin sensitivity, heterogeneity of clinical presentation and constraints on test tolerability. Emerging approaches involve refined cut-off values, risk stratification algorithms combining biochemical and non-fasting markers and point-of-care technologies to enhance accessibility. International guidelines increasingly advocate targeted screening in high-risk groups—such as overweight or obese adolescents, those with a family history of diabetes or associated metabolic abnormalities. Standardising protocols across diverse healthcare settings remains critical to ensure equity in early detection and to guide timely lifestyle and pharmacological interventions aimed at preserving β-cell function and preventing progression to overt diabetes.

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Diagnosis and Screening of Pediatric Diabetes Mellitus publication trend

The graph below shows the total number of articles in diagnosis and screening of pediatric diabetes mellitus across all publications each year (not limited to Nature Index journals).

Technical terms

Fasting plasma glucose (FPG): Concentration of glucose in blood after an overnight fast, used to detect hyperglycaemia.

Glycated haemoglobin (HbA1c): Percentage of haemoglobin covalently bound to glucose, reflecting average blood glucose over the preceding two to three months.

Oral glucose tolerance test (OGTT): Assessment of blood glucose response following ingestion of a standardised glucose load over two hours.

Prediabetes: Intermediate hyperglycaemia characterised by elevated fasting glucose, post-load glucose or HbA1c below diabetic thresholds.

Impaired fasting glucose (IFG): Elevation of fasting plasma glucose below diabetic range, indicating early dysglycaemia.

Impaired glucose tolerance (IGT): Elevated two-hour plasma glucose concentration during OGTT, signalling reduced glucose disposal.

Insulin resistance: Diminished capacity of tissues to respond to insulin, often preceding type 2 diabetes.

Sensitivity and specificity: Statistical measures of a diagnostic test’s ability to correctly identify individuals with and without a condition.

References

1. Prevalence of prediabetes by the fasting plasma glucose and HbA1c screening criteria among the children and adolescents of Shenzhen, China. Frontiers in Endocrinology (2024).
2. Which Is the Most Appropriate Cut-Off of HbA1c for Prediabetes Screening in Caucasian Youths with Overweight or Obesity?. International Journal of Environmental Research and Public Health (2023).
3. Who should return for an oral glucose tolerance test? A proposed clinical pathway based on retrospective analysis of 332 children. Journal of Pediatric Endocrinology and Metabolism (2021).