ESPE Abstracts (2014) 82 P-D-1-3-87

The Natural Evolution of Impaired Glucose Homeostasis Among Obese Adolescents in a High - Risk Diabetes Prone Population

Nehama Zuckerman-Levina,b, Idit Pasternakc, Sami Najjard, Doron Hermonia & Naim Shehadehb

aClait Health Services, Sharon-Shomron district, Israel; bPediatric Diabetes Clinic, Rambam Medical Center, Haifa, Israel; cPediatrics Department, Carmel Hospital, Haifa, Israel; dClalit Health Services, Jisr A-Zarka clinic, Israel

Background: Obesity is increasing worldwide among adults, children and adolescents. The increase in obesity rates facilitated the development of several morbidities including impairment in glucose homeostasis. T2DM is described mainly among minority groups, and in Israel it is more frequent among the Arab population.

Objective and hypotheses: We hypothesized that a correlation exists between the degree of obesity and impaired glucose homeostasis among Arab obese children and adolescents. As such, the aim of the study was to investigate whether this correlation exists in a high – risk diabetes prone Arab population.

Method: 329 children and adolescents aged 10–18 years (mean 13.5±2 y) from an Arab village in Israel with a high incidence of obesity and T2DM, were investigated. 117 (75 girls, 42 boys) obese patients were compared to 212 (131 girls, 81 boys) normal weight controls. Obese patients (BMI percentile >95) were evaluated clinically and their body composition and metabolic status was studied.

Results: Obese patients had a mean BMI of 32.4±6 vs. 20.8±3 in the controls (P<0.00001). Mean fasting blood glucose in the obese sample was 92.8±8 mg/dl and 87.9±6.3 in controls (P<0.00001). Two girls were diagnosed with T2DM, 16.8% had impaired fasting glucose, and 56.7% had pre diabetes by HbA1C definition (>5.7%). Insulin resistance as assessed with the homeostatic model was increased in 80% of patients (6.3±2.5). Lipid profile was normal for age; however C-reactive protein was increased (0.86±0.3).While in the control participants BMI was stable with age (correlation of 0.05), the obese group demonstrated increased BMI with age, with a significant difference between younger and older patients (P<0.0001).

Conclusion: Increased degree of obesity predisposes children and adolescents from a high- risk population to impairment of glucose homeostasis. Identifying these children can prevent future morbidity.

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