Your 13-year-old daughter, at 1,45 m tall and 58 kg, has a BMI of 27,6 kg/m². This places her in the obese category for children and adolescents. Given your diagnosis of type 2 diabetes, your daughter is at high risk for blood sugar disorders and needs to be examined.

Pre-diabetes signifies blood sugar levels higher than normal or impaired blood sugar regulation, yet not severe enough for a diabetes diagnosis. This stage often presents no clear symptoms, with children eating and living normally, which can lead to families overlooking the condition. Without early detection and management, pre-diabetes can advance to type 2 diabetes.

You should seek an examination for your daughter at a pediatric or pediatric endocrinology specialist. The doctor will evaluate her overweight status, assess the risk of blood sugar disorders, and identify any associated metabolic issues.

Doctor Son explains examination results to a parent. *Illustration: Tam Anh Cau Giay General Clinic*

During the examination, the child will undergo a blood sugar check, height and weight measurements, BMI calculation based on age and gender, waist circumference measurement, and blood pressure assessment. The doctor will also gather information on eating habits, physical activity, sleep patterns, screen time, and family medical history.

Additional tests may include a fasting blood sugar test, a blood test measuring glucose attached to hemoglobin (HbA1c), or a glucose tolerance test if deemed necessary. Other potential investigations cover insulin levels, blood lipids, liver enzymes, liver and kidney function, indicators of fatty liver, endocrine disorders, or other conditions associated with obesity.

Should the results indicate pre-diabetes, the primary intervention typically involves lifestyle adjustments. Children should reduce their intake of sugary drinks, bubble tea, sodas, sweets, and fast food. They need to increase vegetables, fiber, and adequate protein while controlling carbohydrate portions. Regular meals and limiting late-night snacking are also crucial. Families must avoid subjecting children to extreme fasting or rapid weight loss regimens, as these can negatively affect growth, psychological health, and long-term eating habits.

Daily physical activity is recommended, including brisk walking, cycling, swimming, playing sports, jumping rope, or other preferred activities. This aims to help children expend energy, enhance insulin sensitivity, manage weight, and mitigate the risk of developing type 2 diabetes.

Individuals should never self-medicate with weight loss or blood sugar-lowering drugs without a doctor's explicit instruction. Early detection of pre-diabetes provides families with the opportunity to implement lifestyle changes, manage weight, and significantly reduce the risk of their children developing type 2 diabetes at a young age.

Master of Science, Doctor Do Tien Son

Pediatric Unit

Tam Anh Cau Giay General Clinic