Background: The diagnosis of increasingly serious in the early years of life obesity has experienced a large epidemiological increased worldwide in recent decades, and especially in our country and in some groups. Many of the metabolic complications (SM) and cardiovascular have their origins in childhood and are closely related to the presence of insulin resistance (IR), which associated complications: hepatic steatosis, endothelial dysfunction, polycystic ovary syndrome (PCOS) dyslipidemia, prediabetes, type 2 diabetes, and asthma. To date there have been described in our type 2 DM in children associated with obesity.
Objective: To study within our cohort of obese children followed in the prevalence of RI Hospital and DMtipo2.
Material and methods: Retrospective cohort of obese children consultation (20002012). BMI >P97 (Orbegozo 2004). Making OGTT (ADA criteria) and criteria for Metabolic Syndrome IFD 2007 (MS). IBM SPSS 18.0 statistical descriptive.
Results: Two hundred and fifty cases initially selected. 54% (n=135) 46% girls (n=115) children. First consultation age: 10.1±2.2 (617). Weight and height at birth: 92% PAEG, 2.7% PEG, 5.4% MEG. BMI (kg/m2) average Z-score+2.8, with DS 0.75 (28.5). Tanner 1 (61%) T24 (35%), T5 (4%). Obesity grade I (44%), grade II (46%), and grade III (7%) severe/morbid (3%). Intolerant OGTT 30/250 (12%), criteria MS 12/250 (5%), and DMtipo2 2/250 (0.8%). Description cases (iconography is provided). Case 1: ♂ 12a7m. Fragile X (+). Disharmonious PEG. Debut glucose 580 mg/dl, insulinemia 29 μU/ml, HbA1c 11.8%. HLA DR3/DR4 (−/−). Ac GAD/IAA (−) requires intensive insulin (glarginelispro)+metformin. Initial BMI SDS +4.3. Weight loss +2.2 SDS. Now exercise+metformin treatment. Case 2: ♀ 13th 8m. Disharmonious PEG. Debut glucose 385 mg/dl, insulinemia 33 μU/ml, HbA1c 10.6%. Requires intensive insulin (glargineglisulide)+metformin. HLA DR3/DR4 (−/−). Ac GAD/IAA (−) initial BMI SDS +3.4. Weight loss+2.8 SDS. Now treatment liraglutide+metformin+exercise test.
Conclusions: Childhood obesity in our country has reached such prevalence and intensity which gives rise to cases of type 2 DM, as described in other age groups and regions.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology