Review on the screening of urine glucose for early diagnosis of type 2 diabetes mellitus in school children and adolescents with obesity in Hong Kong
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Gloria Shir-Wey Pang
,
Thomas Wai-Hung Chung
,
Antony Chun-Cheung Fu
Abstract
Objectives
Obesity and type 2 diabetes mellitus (T2DM) are growing health concerns. Since 2005, Student Health Service (SHS) and Hong Kong Paediatric Society formulated a protocol on urine glucose screening (UGS) for early diagnosis of T2DM in students with obesity in Hong Kong. This study reviews students with T2DM captured by this screening program and compare the data with the Hong Kong Children Diabetes Registry (HKCDR) database, to see if the UGS program facilitates early diagnosis of T2DM.
Methods
Students between the ages of 10–18 years old with age- and sex-specific body mass index (BMI) >97th percentile who attended SHS between the school years from 2005/06 to 2017/18 were recruited for UGS. Those tested positive for random urine glucose underwent diagnostic testing for T2DM according to ADA guidelines. Demographic data and investigatory results from UGS and HKCDR within the same time period were compared.
Results
A total of 216,526 students completed UGS in the said period; 415 (0.19 %) students were tested positive for urine glucose of which 121 students were diagnosed with T2DM. UGS picked up 23 % of the newly diagnosed T2DM cases. When compared to the HKCDR database, students diagnosed via UGS were significantly younger, less obese, and had fewer diabetic related complications. The negative predictive value of UGS is high and can effectively rule out T2DM.
Conclusions
Urine glucose screening is an inexpensive and simple test that allows for early diagnosis of T2DM among obese school students. Other methods including POCT HbA1c can be explored to improve program effectiveness.
Acknowledgments
We would like to thank Youth Diabetes Action for the support to the Hong Kong Childhood Diabetes Registry. We would also like to thank all our students who participated in the Student Health Service and the diabetes registry, as well as Mr. Dick Li (statistics analyst, Research Office, Hong Kong Children’s Hospital) for data analysis.
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Research ethics: The study was reviewed and approved by the Institutional Review Board of all involved hospital units.
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Informed consent: Not applicable.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Research funding: None declared.
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Data availability: The data that support the findings of this study are available from the corresponding author upon reasonable request.
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Articles in the same Issue
- Frontmatter
- Review
- Myoinositol or D-chiro-inositol for PCOS symptoms in adolescents: a narrative review
- Mini Review
- Effects of the COVID-19 pandemic on the incidence of central precocious puberty; a narrative review
- Original Articles
- Evaluation of the role of FTO (rs9939609) and MC4R (rs17782313) gene polymorphisms in type 1 diabetes and their relation to obesity
- Lack of association between month of birth and risk of developing type 1 diabetes in Brazil: a 40-year analysis
- Review on the screening of urine glucose for early diagnosis of type 2 diabetes mellitus in school children and adolescents with obesity in Hong Kong
- Effect of daily zinc supplementation for 12 weeks on serum thyroid auto-antibody levels in children and adolescents with autoimmune thyroiditis – a randomized controlled trial
- Correlation between serum vitamin D level and uterine volume in girls with idiopathic central precocious puberty
- Diagnostic model based on multiple factors for girls with central precocious puberty
- Validity and reliability of parent assessments of pubertal maturation among adolescent girls in Isfahan, Iran
- Newborn screening for primary carnitine deficiency using a second-tier genetic test
- Case Reports
- From neglect to peril: diabetic ketoacidosis unleashing colonic necrosis and perforation in an adolescent girl with type 1 diabetes mellitus
- Unusual onset of Graves’ disease associated with thymic hyperplasia in a 5-year-old girl with congenital bilateral clinical anophthalmia: diagnostic and therapeutic challenges
- Thyroid hormone resistance and large goiter mimicking infiltrative carcinoma in a pediatric patient
- Hereditary hypomagnesemia with secondary hypocalcemia caused by a novel mutation in TRPM6 gene
- Letter to the Editor
- Congenital hyperinsulinism patient with ABCC8 and KCNJ11 double heterozygous variants: a case report with 6 years follow-up
