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TABLE 2.4

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/ethnicity (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 
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/ethnicity (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 
*

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

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