Rising Rate of Diabetes in Kids Is Challenging

Type 2 diabetes, characterized by insulin resistance, used to be called adult-onset diabetes. Unfortunately, the condition is becoming increasingly common in children and teens. With increasing numbers of young people developing insulin resistance, the term “adult-onset” diabetes is no longer appropriate. How can we manage diabetes in kids?

One in Three American Teens Has Prediabetes:

The Centers for Disease Control and Prevention has just reported that nearly one-third of American adolescents now has prediabetes. If that condition progresses to become diabetes, young people who have it are at increased risk for heart disease and stroke as well as metabolic dysfunction. The data were derived from the National Health and Nutrition Examination Survey, which included analysis of fasting blood glucose and HbA1c, another way to measure blood glucose.

Prediabetes does not automatically lead to diabetes in kids. If youngsters can change their diets and become more physically active, they may well be able to reverse the condition. But meeting the definition of prediabetes indicates that a teen’s pancreas is under stress and may need some extra care to stay healthy.

How Do You Treat Diabetes in Kids?

At one time, there was relatively little information available to guide doctors in treating them. A seminal study published in the New England Journal of Medicine compared three different treatment regimens in youngsters between 10 and 17 years old (New England Journal of Medicine, June 14, 2012). Only about half the children were able to get good blood sugar control with metformin alone. Experts admitted that these results were quite disappointing. We should not be surprised, however. Metformin alone is not always successful in helping adults control their blood sugar either, although it can help reverse prediabetes.

Using Modern Anti-Diabetes Drugs:

Just as with adults, the more recent medications can make a difference for treating diabetes in kids. GLP-1 agonists to treat obesity include semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound). These medicines and the SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin, ertugliflozin) appear to be quite effective in controlling blood sugar even in adolescents (Nutrients, Nov. 27, 2024).

A meta-analysis of 12 randomized controlled trials concluded that dulaglutide (Trulicity) made the biggest difference in reducing HbA1c, a longer-term measure of blood glucose (World Journal of Diabetes, July 15, 2025). In addition, the “flozin” drugs named in the previous paragraph were modestly effective.

Not surprisingly, the authors closed their abstract with this observation:

“Larger RCTs with longer follow-up durations are needed to guide better therapeutic decision making.”

Increasing rates of diabetes in kids makes this need for research more urgent. Diabetes increases the risk of many serious complications, including kidney or heart disease, infertility or amputations. The longer a person has diabetes, the more worrisome the risk becomes. Some pediatricians would like to see more robust community efforts to address the rising rates of obesity in young people to prevent type 2 diabetes in the first place.