What to Do When Your Child Is Diagnosed with Pre-Type 2 Diabetes (Prediabetes)

Key takeaways

• Prediabetes is usually identified through blood tests, particularly in children with certain risk factors.
• Your GP can advise whether further testing, ongoing monitoring or a specialist referral is needed.
• Small family changes can make a difference. Balanced meals, regular physical activity, good sleep and fewer sugary drinks can help support healthy blood sugar levels.
• Early support matters. With appropriate medical guidance and healthy habits, blood sugar levels may improve, and your child can build a strong foundation for long-term health.

What does prediabetes mean in children?

Prediabetes occurs when your child’s blood sugar (glucose) levels are higher than normal but below the range used to diagnose type 2 diabetes.

To understand why this happens, it helps to know a little about insulin. Insulin is a hormone that helps move sugar from the bloodstream into the body’s cells, where it’s used for energy.

Sometimes, the cells don’t respond to insulin as well as they should. This is called insulin resistance. The pancreas then has to produce more insulin to keep blood sugar levels under control. Over time, it may become harder for the body to maintain normal blood sugar levels.

This is when prediabetes can develop.

A prediabetes result is worth taking seriously, but it isn’t a reason to panic. It doesn’t mean your child will definitely develop type 2 diabetes. With appropriate medical guidance and supportive lifestyle changes at home, blood sugar levels will improve. Also, in many children metformin therapy may help reverse the prediabetes.

It’s also important to remember that this isn’t about blame. Many factors can influence a child’s risk, including family history, genetics, growth and development.

How is prediabetes diagnosed in children?

Prediabetes usually doesn’t cause noticeable symptoms. Your child may continue eating, playing and going about their daily activities without anything seeming different.

That’s why blood tests are important when a doctor believes a child may be at risk.

Three tests are commonly used to assess blood sugar levels:

• Fasting blood glucose test: Measures blood sugar after your child has fasted for at least eight hours.
• HbA1c test: Measures average blood sugar levels over approximately the past two to three months. Your child doesn’t usually need to fast for this test. Usually an HbA1c > 6.0 but < 6.5% indicates risk for Prediabetes, while > 6.5% is suggestive of actual T2D
• Oral glucose tolerance test (OGTT): Measures blood sugar before and after your child drinks a glucose solution. Further blood tests are taken over the following two hours to see how their body processes sugar.

Your doctor will decide which test is appropriate based on your child’s circumstances. They may also recommend repeating a test or using another method to better understand the result.

When should children be screened for prediabetes?

Not every child needs routine blood sugar screening. In Australia, the Australasian Paediatric Endocrine Group recommends targeted screening for children who have certain risk factors.

For non-Indigenous children, screening may be considered after age 10 or when puberty begins, whichever happens first, if they are above a healthy weight and have at least one additional risk factor.

These risk factors can include:

• A parent or close family member with type 2 diabetes.
• A mother who had diabetes during pregnancy.
• A family background associated with a higher risk of type 2 diabetes.
• Overweight and obesity with elevated waist circumference 
• Signs of insulin resistance, such as darkened, thickened patches of skin around the neck or armpits with excessive skin tags.
• Other health conditions associated with insulin resistance, including fatty liver disease or polycystic ovary syndrome, or as it is now called, polyendocrine metabolic ovarian syndrome or PMOS

Screening recommendations differ for Aboriginal and Torres Strait Islander children, as well as Māori and Pacific Islander children. Your child’s doctor can advise whether screening is appropriate and when it should take place.

What should you do after your child receives a prediabetes result?

A prediabetes result can leave you with more questions than answers. Rather than trying to make several changes at once, start by understanding the result and getting the right support.

Here are four practical steps to help you move forward.

1. Arrange a follow-up with your GP

Your GP is the best person to help you understand what your child’s blood test results mean.

Ask whether the result needs to be confirmed with another test, what may be contributing to the higher blood sugar levels and how often your child should be monitored.

It’s also worth discussing any other health factors that may need attention. This helps ensure the next steps are appropriate for your child’s age, development and individual needs.

2. Ask whether specialist support is needed

Depending on your child’s results and overall health, your GP may recommend seeing a paediatric endocrinologist.

A paediatric endocrinologist specialises in children’s hormones, growth and metabolism. They can assess insulin resistance, investigate related health concerns and help guide ongoing care where needed.

Not every child with prediabetes will require specialist treatment, but your GP can help determine whether a referral would be beneficial.

3. Make healthy changes as a family

Small, manageable changes at home can make it easier for your child to build healthy habits without feeling singled out.

You don’t need to overhaul your family’s routine overnight. Start with everyday choices that support everyone’s health, such as:

• Enjoying balanced meals: Include a variety of vegetables, fruit, whole grains and other nutritious foods.
• Choosing water more often: Reduce sugary drinks, including soft drinks, cordial and sweetened juices.
• Making movement enjoyable: Encourage activities your child enjoys, whether that’s swimming, riding a bike, dancing, playing sport or going for a family walk.
• Supporting good sleep: Establish consistent bedtimes and routines that give your child enough sleep for their age.
• Creating healthy habits together: Involve the whole family so your child feels supported rather than responsible for making changes alone.

The aim is to create a positive home environment where healthy choices become part of everyday life. Avoid restrictive diets or making your child feel self-conscious about their weight. Any changes to eating habits or weight management should support their growth and development.

4. Keep up with follow-up appointments

Improving blood sugar levels takes time, and your child’s health needs may change as they grow.

Your doctor can recommend how often blood tests and check-ups are needed. These appointments help monitor blood sugar levels, assess your child’s growth and determine whether the current approach is working.

Even if your child’s results improve, continue following your doctor’s advice about ongoing monitoring.

What symptoms should parents look out for?

Although prediabetes usually doesn’t cause symptoms, it’s important to recognise possible warning signs of diabetes.

Contact your child’s doctor promptly if you notice that your child:

• Is urinating more frequently than usual.
• Has started wetting the bed after previously staying dry at night.
• Feels unusually thirsty.
• Seems much hungrier than usual.
• Is unusually tired or lacking energy.
• Is losing weight without trying.

These symptoms don’t automatically mean your child has diabetes, but they should be assessed urgently if need be in the emergency department with a simple blood finger-prick glucose blood test! rather than being ignored. The more common form of diabetes in children is still Type 1 Diabetes (T1D) and requires urgent assessment in hospital emergency to confirm the diagnosis and start insulin therapy.

If your child develops vomiting, abdominal pain, deep or rapid breathing, or unusual drowsiness alongside these symptoms, seek emergency medical care in hospital. These can be signs of a serious diabetes-related complication called diabetic ketoacidosis or DKA.

Where can families get support with childhood prediabetes?

Receiving a prediabetes result can feel overwhelming, but you don’t have to work through it alone.

Your GP can help you understand your child’s results and coordinate any further care. A paediatric endocrinologist can provide specialist guidance when needed, while other health professionals can support your family with nutrition, physical activity and sustainable lifestyle changes.