Impaired glucose tolerance is present in 25 percent of obese children and 21 percent of obese adolescents, some of whom also have clinically asymptomatic or silent type 2 diabetes.
These are among findings of the first study to document the prevalence of impaired glucose tolerance in obese children.
Insulin resistance is an important risk factor linked to the development of impaired glucose tolerance in severe childhood obesity, this United States study suggests. The findings add weight to concerns about an emerging paediatric epidemic of type 2 diabetes and, if that cannot be averted, the consequences as affected children become adults and the long-term complications of the disease develop.
Although severe obesity is known to play a prominent role in pathogenesis of the disease, it has been unknown until now whether it is a risk factor for impaired glucose tolerance.
In adults, type 2 diabetes develops over a long period; most patients initially have impaired glucose tolerance, an intermediate stage in the natural history of this disease. Because progression from impaired glucose tolerance to frank diabetes can be delayed or prevented, greater emphasis is now placed on its early detection.
This work among a multiethnic cohort of children and adolescents was done by Ranjana Sinha and colleagues from the Departments of Pediatrics and Internal Medicine, the Children's General Clinical Research Center, and the Division of Biostatistics, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut.
Of the 167 participants, 55 were aged four years to 10 years, and 112 were aged 11 years to 18 years. All had been referred to Yale's Pediatric Obesity Clinic between 1999 and 2001.
Researchers used the two-hour oral glucose-tolerance test, along with measurements of insulin and C peptide, to identify impaired glucose tolerance. Silent type 2 diabetes was identified in four percent of the obese adolescents.
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