When a person has prediabetes, their blood glucose level (also called blood sugar level) is higher than normal, but it is not yet at the level to call it diabetes. Having prediabetes doesn't mean your child will definitely get diabetes, but it makes it more likely. People with diabetes have high blood glucose levels (called hyperglycemia) that remain too high over time. Diabetes can lead to serious medical problems.

Prediabetes happens more often in kids and teens who carry extra weight, particularly when it is in the belly area. Weight loss, physical activity, and healthy eating can improve prediabetes, prevent diabetes, and boost overall health.

Follow your healthcare provider's instructions for:

• Giving your child any medicines
• Making any appointments with specialists
• Scheduling follow-up visits

For healthy eating:

• Work with a dietitian (food specialist), who focuses on prediabetes, to create a meal plan.
• Encourage your child to:
  • Eat when hungry and stop when full — they don't need to finish everything on their plate.
  • Eat a healthy diet that includes protein such as chicken, fish, eggs, beans, and nuts; plenty of fresh fruits and vegetables; dairy products like milk and cheese; and whole-grain breads and cereals.
  • Avoid ultra-processed foods such as sugary drinks, sweetened breakfast cereals, cookies, chicken nuggets, and hot dogs as much as possible.
  • Choose healthy snacks like fresh fruits, vegetables, and nuts.
  • Drink plenty of water every day and avoid soda, juice, and other sugary drinks. Sugary drinks can make prediabetes worse.

For healthy habits:

• Encourage your child (and the whole family) to be physically active for at least 60 minutes every day.
• Go for family walks, hikes, and bike rides and play active family games (like frisbee or hide and go seek) as often as possible.
• Help your child find enjoyable ways to be active, such as:
  • Team sports (like soccer or basketball)
  • Individual sports (like gymnastics or martial arts)
  • Walking, swimming, or going to the gym
• Help your child limit their screen time so it doesn't prevent them from getting enough sleep (at least 8 hours) and plenty of physical activity.

• Your child has symptoms of hyperglycemia such as:
  • Extreme thirst
  • Peeing often or in large amounts
  • Unexplained weight loss
• You have trouble keeping your child on a healthy diet. Your healthcare provider can refer your child to a dietitian for more guidance.

What happens when someone has prediabetes? Normally, when a person eats, the body breaks the food down into glucose (sugar). The pancreas makes insulin, a hormone (chemical messenger) that lets glucose enter the cells for energy. This keeps the blood sugar in a healthy range.

In someone with prediabetes, the cells don't respond to insulin as well. The pancreas responds by making more insulin, but it can't keep up and the blood sugar level gets high. If it stays high, it can become type 2 diabetes.

Are there different kinds of diabetes? Yes, there are two kinds of diabetes, types 1 and 2. In type 1, the pancreas doesn't make enough insulin. People with type 1 diabetes do not usually carry extra weight. In type 2, the pancreas makes insulin, but the cells don't respond normally to it. People with type 2 diabetes usually carry extra weight. Prediabetes can lead to type 2 diabetes (but not type 1).

What happens in diabetes? In both types of diabetes, the blood sugar stays high, and over time, damages blood vessels and nerves and causes problems in the heart, kidneys, and eyes.

What tests are done to check for prediabetes? Healthcare providers usually order a:

• Fasting blood glucose test (blood drawn after your child hasn't eaten for at least 8 hours)
• Hemoglobin A1C test (shows the average blood glucose levels over the past few months)

Your provider may order other tests as needed.

How can I help my child eat a better diet and become more active? Try to make changes together as a family. This helps your child feel supported instead of singled out. Plan healthy dinners and cook together. Take a walk after dinner, visit the playground, ride bikes, or play active games outside. Making healthy eating and regular physical activity part of your family routine is one of the best ways to keep the whole family healthy.