Background: The prevalence of type 2 diabetes (T2D) is significantly increased in pediatric population, which is affected by obesity worldwide. The progression of insulin resistance to T2D in obese children has been shown to be faster than in adults. Therefore, screening for T2D seems meaningful especially in high risk groups such as children and adolescents with obesity, family history of T2D, and those with clinical features of insulin resistance (hypertension, dyslipidemia, polycystic ovarian syndrome, or acanthosis nigricans).
Aim of work: To estimate the prevalence of prediabetes and T2D and their associated risk factors among obese and overweight high risk Egyptian children and adolescents using strip HbA1c as a screening test.
Patients and methods: A cross-sectional study conducted on 339 children and adolescents (between 5 and 18 years) at risk for T2D recruited from Cairo University Childrens Hospital outpatient clinics over a period of 10 months. Patients with hemoglobinopathies, known T1D and children on steroid therapy were excluded. Study population was subjected to full history taking, clinical evaluation, anthropometric measurements, and screened for prediabetes and T2D using strip HbA1c and OGTT. Subjects with abnormal HbA1c (defined as HbA1c >5.7%) were subjected to serum HbA1c for confirmation.
Results: Prevalence of prediabetes and T2D using OGTT were 15% and 0.3% respectively, while strip HbA1c showed higher prevalence for prediabetes and T2D (31%). Strip HbA1c showed 81.63% sensitivity & 76.84% specificity at cut off point ≥5.6 for prediabetes and diabetes. Moderate direct significant correlation was detected between strip HbA1c and each of FBS (r=0.39, P=0.001) and OGTT (r=0.26, P=0.0001). There was a strong correlation between venous and capillary HbA1c in diagnosing diabetes. Significant association between age and prediabetes/T2D was found using both OGTT and strip HbA1c (P value of 0.03 & 0.001 respectively). Physical inactivity, puberty, abdominal obesity, and presence of hirsutism were significantly associated with prediabetes and T2D.
Conclusion: T2D and prediabetes are common conditions in obese and overweight Egyptian children and adolescents based on OGTT. Higher prevalence was detected based on strip HbA1c. Strip HbA1c had high sensitivity and specificity compared to OGTT and can be used for screening for prediabetes and T2D in high risk group.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology