Childhood obesity in a population at high risk for type 2 diabetes

Objectives: To determine the prevalence of obesity and investigate its association with fasting glucose and insulin among children and adolescents in a population at high risk for type 2 diabetes. Design: A cross-sectional screening survey involving anthropometry and fasting serum levels of glucose and insulin. Setting: A remote aboriginal (Ojibwa-Cree) community in northern Manitoba, Canada. Participants: All children aged 4 to 19 years in the community were invited to participate, with a response rate of 82% (n = 719). Main outcome measures: Obesity is defined as body mass index exceeding the 85th percentile of the National Center for Health Statistics reference data. The diagnosis of diabetes and impaired fasting glucose is based on the new criteria of the American Diabetes Association. Results: There is a high prevalence of obesity, with 64% (female) and 60% (male) exceeding the 85th percentile and 40% (female) and 34% (male) exceeding the 95th percentile. Body mass index is a significant predictor of both glucose and insulin in both sexes, independent of age. Obese children are at increased risk of being classified as having diabetes or impaired fasting glucose (odds ratio 5.1, 95% CI 1.51, 17.0). Conclusions: The early onset of type 2 diabetes in childhood is increasingly observed in many populations. Childhood obesity is a strong risk factor. Early detection and intervention directed at obesity are potential strategies to avert the long-term consequences of type 2 diabetes.