Journal
DIABETES CARE
Volume 28, Issue 4, Pages 902-909Publisher
AMER DIABETES ASSOC
DOI: 10.2337/diacare.28.4.902
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Funding
- NCRR NIH HHS [M01 RR 00125, M01 RR 06022] Funding Source: Medline
- NICHD NIH HHS [R01 HD 28016, R01 HD 40787, K24 HD 01464] Funding Source: Medline
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OBJECTIVE - Type 2 diabetes in obese youth is an emerging problem. The metabolic and anthropometric predictors of change in glucose tolerance status in obese youth are unknown. RESEARCH DESIGN AND METHODS - A total of 117 obese children and adolescents were studied by performing an oral glucose tolerance test (OGTT) at baseline and after similar to 2 years. Data from both OGTTs and changes in weight were examined to identify youth at highest risk for developing diabetes and the factors that have the strongest impact on glucose tolerance. RESULTS - Eighty-four subjects had normal glucose tolerance (NGT) and 33 impaired glucose tolerance (IGT) at baseline. Eight subjects (all of whom had IGT at baseline) developed type 2 diabetes, whereas 15 subjects with IGT reverted to NGT. In this cohort, severe obesity, impaired glucose tolerance, and African-American background emerged as the best predictors of developing type 2 diabetes, whereas fasting glucose, insulin, and C-peptide were nonpredictive. Changes in insulin sensitivity, strongly related to weight change, had a significant impact on the 2-h glucose level on the follow-up study. CONCLUSIONS - Severely obese children and adolescents with IGT, particularly of African-American descent, are at very high risk for developing type 2 diabetes over a short period of time. Parameters derived from an OGTT and not fasting samples can serve as predictors of changes in glucose tolerance.
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