ESPE Abstracts

Background: Childhood obesity is a growing global problem that linked with health issues including type II diabetes. Early screening and diagnosis using OGTT and/or HbA1c of obese children is recommended in order to minimize type II diabetic risk. OGTT requires fasting and two venesections impeding the child’s compliance. In contrast, hemoglobin A1c (HbA1c) is a convenient test and evaluation of HbA1C as a diagnostic tool of type II diabetes in the obese children compared to OGTT is momentous.

Objectives: To evaluate the correlation between HbA1c and 2h-OGTT level for the diagnosis of type II diabetes in obese children above10 years of age who attended the Endocrine and Diabetes clinic.

Method: A descriptive analytical study was conducted using routine simultaneous screening results of OGTT and HbA1c of all the obese (Age and gender specific BMI ≥95th percentile) children over 10 years visiting Endocrine and Diabetes Unit Lady Ridgeway Hospital for Children, Colombo, Sri Lanka from 1st of February 2021 to 31st of August 2021.

Results: A total number of 189 children were recruited to the study. The mean age 11.8 years (male 68% and female 32%), mean weight and the mean BMI were 60 kg and 26.15, respectively. The majority (79%) of the children were between 10 to 12 years of age and the most of them (76%) had a family history of obesity. The mean 2h-OGTT was 6.44 and according to OGTT criteria 3.7% were in the diabetes group,14.81% were in the impaired glucose tolerance group and 81.48% were in the normal glucose tolerance group. Mean HbA1c was 5.5 and HbA1c categorized the 4.23%, 28.57%, and 67.2% of children into diabetes, pre diabetic and normal, respectively. A significant correlation between 2h-OGTT and HbA1c was observed by Fisher's Exact test(P<0.001).

Discussion: Correlation between HbA1c and OGTT level for the screening of type II diabetes in obese children was observed. Other studies also showed HbA1c is a reliable indicator of diabetes risk in the paediatric population. Some studies concluded that HbA1c alone is a substandard determinant of paediatric prediabetes population unless it is collaborated with other clinical evidence. Therefore, data verifying HbA1c in predicting type II diabetes among children necessitate further large-scale studies.

Conclusion: Our findings indicate the potential use of HbA1c for the diagnosis of type II diabetes in Sri Lankan obese children. However, HbA1c alone is a poor discriminator of prediabetes in the same population.