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Background: Type 2 diabetes mellitus (T2DM) once considered an adult disease is now being reported in children and adolescents all over the world due to a parallel increase in obesity. Prediabetes is an intermediate stage between no diabetes and diagnosis of DM. Objective: To screen at risk asymptomatic adolescent children for prediabetes state. Methods: A prospective descriptive study was conducted in the outpatient department of a tertiary care hospital in South India. All adolescent children between the age group of 10 and 18 years with evidence of overweight as per the World Health Organization age and sex specific centile charts for body mass index (BMI) were enrolled. The study period was 18-month. Anthropometric and demographic data were collected among these subjects and investigated for oral glucose tolerance test (OGTT), fasting blood glucose (FBG), and glycosylated hemoglobin (HbA1c) as per the designed protocol. Results: Prediabetes was diagnosed in 13% of the study population with a combination of OGTT, FBG, and HbA1c tests. Prediction of prediabetes by OGTT was 10%, HbA1c 5% and by FBS was 3%. Combination of impaired glucose tolerance test with HbA1c had high sensitivity (92%) and specificity (100%). Conclusions: Our study had 13% population with increasing risk of developing T2DM. Further longitudinal studies are required to screen at risk asymptomatic adolescent children for prediabetes.

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Background: Exposure to diabetes in utero has been established as a significant factor for certain component of the clinical syndrome. Although complications of atherosclerosis occur in adult life, the process begins in early childhood. Hence, measuring aortic intima-media thickness (AIMT) in the newborn is a feasible, accurate, and sensitive marker of atherosclerotic risk. Objective: The objective of the study was to find an association of AIMT with cord blood lipid levels and anthropometric factors. Methods: Babies born to diabetic mothers (gestational diabetes mellitus/type 2 diabetes mellitus (34 weeks–42 weeks) who were taken as one group and babies born to non-diabetic mothers (34 weeks–42 weeks) who were taken as the other group were enrolled in this study. Lipid values were measured of umbilical cord blood, collected immediately after delivery. Atherogenic-indices were calculated; neonatal anthropometric measurements were taken within 24 h after delivery. Abdominal AIMT (aAIMT) was measured within 4 days of delivery using a high-resolution ultrasound B mode by a trained radiologist. Maternal age, parity, height, pre-pregnancy weight, gestational age, and other investigations were taken from maternal records. Results: In this study, birth weight (BW) was positively correlated with triglycerides (TG), cholesterol, high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), and atherogenic-indices, whereas, it was negatively correlated with low-density lipoprotein (LDL) (p<0.01). A positive correlation was found between aAIMT and BW, abdominal circumference, TG, cholesterol, HDL, LDL, VLDL, and atherogenic-indices (p<0.001). Conclusions: In this study, infants born to diabetic mothers had higher anthropometry, lipid values, aAIMT compared to babies born to non-diabetic mothers without risk factors.

Background: Childhood obesity is a rising epidemic and a major public health problem with the risk for type 2 diabetes mellitus, hypertension and cardiovascular disorders in later life. Neck circumference (NC), a marker of upper body subcutaneous adipose tissue distribution can predict higher metabolic risk. The aim of the present study was to evaluate the association between neck circumference (NC) and obesity.Methods: This cross-sectional prospective observational study was conducted in Bangalore in the month of October 2016. 172 male and 161 female students, aged 13-17 years were screened. Anthropometric markers of obesity measured included body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and compared with neck circumference (NC) of the same subjects. Pearson’s correlation coefficient was calculated between neck circumference and other obesity indices, and receiver operating characteristic curve analysis was used to determine the best cutoff value of neck circumference in predicting high BMI. Results: Overall, 13.2% boys and 9.9% girls were found overweight/obese. The mean BMI was 25.27±2.09kg/m2 and25.17±2.23kg/m2, mean neck circumference was 33.43±2.3cm and 31.50±1.4 in overweight/obese boys and girl respectively. All of the anthropometric parameters were found to be significantly higher in overweight/obese children than with their normal weight peers and higher in boys compared to girls. The neck circumference in boys was significantly greater than girls and higher in overweight/obese with P<0.001. The best cut-off value of neck circumference by ROC to identify boys with a high BMI was 32cm with sensitivity of (81.82%), specificity (89.06%), and for girls was 30cm with sensitivity of (84.85%), specificity (87.5%). Neck circumference had a strong positive correlation with other anthropometric measures BMI, WC, waist hip ratio in both boys and girls (p <0.001).Conclusions: Neck circumference significantly correlated with other indices of obesity. It can be used with great reliability to screen overweight and obesity in children. NC can be considered as a simple, time saving and inexpensive clinical tool for detection of obesity in large population-based studies in children and adolescents.