ESPE Abstracts

Background: The increased prevalence of youth obesity has led to raised youth-onset type 2 diabetes mellitus (T2DM), as well as the intermediate condition of prediabetes. Diagnosis of prediabetes can help preventing of the development of T2DM.

Aims: to study the frequency, clinical laboratory diagnostics and relationship of prediabetes with SDS BMI in obese adolescents.

Materials: The study involved 95 adolescents with obesity. Inclusion criteria: SDS BMI≥2.0, Tanner stage ≥II, age <18.0 years, exclusion criteria: diabetes mellitus. The research consisted of the estimate SDS BMI and the measure of HbA1c, insulin, fasting plasma glucose (FPG) and 2-hour plasma glucose (2hPG) during an oral glucose tolerance test (OGTT). Prediabetes in adolescents was diagnosed using American Diabetes Association criteria. Data was analyzed by using SPSS Statistics for Windows, Version 26.0.

Results: Prediabetes was diagnosed in 42.1% (40/95) of cases. One of the three criteria for prediabetes was detected in 85% (34/40), two or more - in 15% (6/40) of cases. In the one-criterion prediabetes group, impaired fasting glycemia (IFG) accounted for 64.7% (22/34), HbA1c≥5.7% - 29.4% (10/34), impaired glucose tolerance (IGT) – 5.9% (2/34) of cases. In the group with two or more criteria, IGT in combination with HbA1c≥5.7% was detected in 50% (3/6) of cases, IGT in combination with IFG - 33.3% (2/6), IFG in combination with HbA1c≥5. 7% - 6.7% (1/6). There was no combination of all three criteria for prediabetes in this sample of patients. There were statistically significant differences between the indices of groups with prediabetes and normal glucose metabolism: FPG (mean 5.63±0.49; 95% CI: 5.48-5.79 vs 5.03±0.42; 4.92-5.15 mmol/l, P<0.001); 2hPG (mean 7.04±0.93; 95% CI: 6.74-7.34 vs 6.23±0.82; 6.01-6.46 mmol/l, P<0 /001); HbA1c (mean 5.5±0.31; 95% CI: 5.39-5.59% vs 5.2±0.25; 5.15-5.29%, P<0.001). There were no significant differences in SDS BMI between groups with prediabetes (n=40) and unimpaired carbohydrate metabolism (n=55) (mean SDS BMI 3.1±0.54 vs 3.1±0.54, respectively; P=0.975). In addition, there were no significant differences in SDS BMI between groups with the one-criterion prediabetes group (n=34) and two or more criteria (n=6) (mean SDS BMI 3.1±0.56 vs 3.3±0.39, respectively; P=0.271).

Conclusions: Prediabetes was detected in almost half of obese adolescents; in most cases it was represented by one criterion and in the order of occurrence in the following sequence: IFG, HbA1c≥5.7%, IGT. No relationship established between the index of SDS BMI and the development of prediabetes.