Progression from impaired glucose tolerance to type 2 diabetes in obese children and adolescents: a 3–6-year cohort study in southern Thailand

Somchit Jaruratanasirikul; Sudarat Thammaratchuchai; Maneerat Puwanant; Ladda Mo-suwan; Hutcha Sriplung

doi:10.1515/jpem-2016-0195

Article

Progression from impaired glucose tolerance to type 2 diabetes in obese children and adolescents: a 3–6-year cohort study in southern Thailand

Somchit Jaruratanasirikul , Sudarat Thammaratchuchai , Maneerat Puwanant , Ladda Mo-suwan and Hutcha Sriplung

Published/Copyright: October 14, 2016

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 29 Issue 11

Abstract

Background:

Childhood obesity is associated with abnormal glucose metabolism and type 2 diabetes mellitus (T2DM). This study evaluated the prevalence of abnormal glucose metabolism in asymptomatic obese children and adolescents, and determined the percentage of T2DM development after 3–6 years of follow-up.

Methods:

During 2007–2013, 177 obese children and adolescents who had normal fasting plasma glucose (FPG<100 mg/dL) were given an oral glucose tolerance test (OGTT). The participants were classified into four groups: normal glucose tolerance (NGT), NGT-hyperinsulinemia (NGT-HI), impaired glucose tolerance (IGT), and diabetes mellitus (DM). Blood chemistries, including FPG, glycated hemoglobin, and lipid profiles, and liver function test were performed every 6–12 months or when the patient developed any symptom or sign indicative of diabetes.

Results:

Glucose metabolism alterations were detected in 81.4% of the participants: 63.8% with NGT-HI, 15.3% with IGT, and 2.3% with T2DM. The median levels of homeostasis model assessment-insulin resistance (HOMA-IR) in patients with IGT (8.63) were significantly greater than those in the patients with NGT (4.04) (p<0.01). During the follow-up, 22 patients (14.4%) developed T2DM significantly more from the IGT group (nine of 33 cases, 27.3%) than the NGT-HI group (12 of 108 cases, 11.1%) (p=0.022). The predicting parameters for T2DM conversion were weight status, body mass index (BMI), FBG, fasting insulin, alanine transaminase (ALT) levels, and HOMA-IR.

Conclusions:

Glucose metabolism alteration was commonly found among obese adolescents. Factors associated with T2DM development were greater weight status and the severity of insulin resistance as shown by higher HOMA-IR levels.

Keywords: impaired glucose tolerance; insulin resistance; obesity; type 2 diabetes mellitus

Corresponding author: Somchit Jaruratanasirikul, MD, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand, Phone: +66-074-429618, Fax: +66-074-429618

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2016-5-18

Accepted: 2016-9-15

Published Online: 2016-10-14

Published in Print: 2016-11-1

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Articles in the same Issue

https://doi.org/10.1515/jpem-2016-0195

Keywords for this article

impaired glucose tolerance; insulin resistance; obesity; type 2 diabetes mellitus