Insulin resistance and impaired glucose tolerance in obese children and adolescents

Abstract

In developed countries, obesity prevalence has strongly increased in the last decades. This has also been observed in children and adolescents. Until recently, type 2 diabetes mellitus was considered very rare among children and adolescents; however, in the last decades, some cases have been observed mainly in obese adolescents of some minority populations. The aim of our study was to assess the prevalence of type 2 diabetes, impaired glucose tolerance (IGT) and insulin resistance, and the metabolic features, in obese children and adolescents. We have studied 95 obese children and adolescents, 53 males and 42 females, aged 4-16 years. The prevalence of IGT in obese children and adolescents studied was 7.4%; there was not any child with type 2 diabetes. Fasting glucose and insulin serum concentrations did not show significant differences between obese children with or without IGT; however, 120 minutes after an oral glucose tolerance test, glucose and insulin serum concentrations showed statistically significant differences between both groups. Insulin resistance is defined as a HOMA index higher than 4. The prevalence of insulin resistance in obese children studied was 35.8%. Trygliceride serum concentrations were higher and HDL-C serum concentrations were lower in obese children with IGT than in those without IGT, but the differences were not statistically significant. IGT and insulin resistance are frequent in obese children and adolescents; early treatment in obese children and adolescents with IGT constitutes a strategy of reversing progression to beta-cell failure and in preventing type 2 diabetes.

Micro-environmental and socio-demographic determinants of childhood obesity

“…The prevention and treatment of obesity among children and adolescents are important to reduce the risk of health complications in both childhood and adulthood. 3,4 Selection of risk groups would also be suitable for optimisation of economic resources.…”

Prevalence of impaired glucose tolerance test and diabetes in overweight, obese and apparently healthy school going adolescents

“…[15][16][17][18] In Taiwan, the rate of diagnosis of T2DM in the screening program was 0.9 percent and 1.53 percent in boys and girls, respectively in community level. 19 Prevalence of prediabetes was 19.2 percent in 280 overweight Japanese children.…”

“…[15][16][17][18]22 Study conducted in New Delhi has found the prevalence of IGT to be 18.2 percent amongst obese children.8 Increasing prevalence of type 2 diabetes among children in India and other counties has been attributed to epidemic of obesity and overweight among children. Sinha and colleagues have reported the prevalence of impaired glucose tolerance to be 21 percent amongst obese adolescents in the U.S.22 Similarly, study done in Germany has reported a prevalence of IGT as 36.3 percent and T2DM as 5.9 percent amongst obese adolescent.…”

Endocrinologic and Metabolic Abnormalities and Related Factors in Obese Children and Adolescents

“…Bu çalışmada, insülin direncinde gruplar arasında anlamlı fark görülürken BAG ve BGT arasında fark gösterilmemiştir. Literatürde çocuklarda obezite ile ilişkili insülin direnci ve glukoz metabolizması bozukluklarının sıklığı ile ilgili çok farklı sonuçlar yayınlanmıştır (25)(26)(27)(28)(29)(30)(31)(32). Çalışmalar arasındaki farklar, çalışma için seçilen populasyon, yaş dağılımı, coğrafi şartlar ve beslenme alışkanlıkları ile direkt olarak ilişkili görünmektedir.…”