Background: Obesity is a major risk factor for developing type 2 diabetes mellitus (T2DM). Despite the obesity epidemics, the incidence of childhood T2DM is not increased.
Objective and hypotheses: To assess the β-cell reserve expressed as an oral glucose disposition index (GDIo), an independent predictor of developing T2DM.
Method: A total of 80 adolescents (61.3% girls), aged from 10.0 to 17.6 years (mean age 13.59±2.34 years), with age- and gender-specific BMI over 95th percentile and waist circumference (WC) over 90th percentile, were included. The participants underwent anthropometry, fasting blood analyses, oral glucose tolerance test (OGTT), and abdominal ultrasonography. Insulin sensitivity was estimated as 1/fasting insulin; insulin response as the change in insulin divided by the change in blood glucose (BG) from 0 to 30 min and GDIo as a relation between insulin sensitivity and β-cell function.
Results: At fasting, a total of 50 adolescents (62.5%) were normoglycemic and 30 (37.5%) were with impaired fasting glucose (IFG). After OGTT subjects were divided into three categories depending on 2 h postload glucose levels: normal glucose tolerance 63 (78.8%); impaired glucose tolerance (IGT) 16 (20.0%); and T2DM 1 (1.3%). The mean GDIo was 2.2450±2.30 mM−1 (boys 2.8057±1.93, girls 1.8991±2.46, P=0.096). The group with the lowest GDIo consisted of 31.9% of all girls vs 13.8% of all boys. The GDIo decreased significantly with increasing of 2 h postload BG levels (P=0.042). The former also had a strong relationship with the family history of obesity (P=0.005) and showed no associations with T2DM family history.
Conclusion: The current study confirmed the low frequency of T2DM in paediatric population and suggested a stronger correlation with obesity and future disease risk. The results in females deserve further exploration.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology