Prevalence of prediabetes in children and its association with risk factors
DOI:
https://doi.org/10.18203/2349-3291.ijcp20193705Keywords:
Glycosylated hemoglobin, Fasting blood sugar, Obesity, Oral Glucose tolerance test, Prediabetes, Waist to hip ratioAbstract
Background: Type 2 Diabetes is becoming more common at younger age group. It is important to screen children and adolescents for prediabetes to prevent long-term complications of diabetes. This study was conducted to study the prevalence of prediabetes in children and its association with risk factors
Methods: It is a Prospective hospital-based study. Children aged 6 to 18 years admitted in the Pediatric ward of tertiary care hospital were included. Study was done over a period of 2 years November 2015-October 2017. Participants were screened to find out the prevalence of prediabetes. Prediabetes was defined as fasting glucose concentration (FBS)of 100-125 mg/dl or a HbA1c value of between 5.7% and 6.4%, or a two-hour post-glucose tolerance concentration (OGTT) of 140-199mg/dl.
Results: 607 children participated in the study.56.3% were males. Prevalence of Prediabetes was 20.4% with a combination of OGTT, FBS and HbA1c tests. Prevalence by OGTT was 5.9%, HbA1c 4.1% and by FBS was 17.1%. Higher prevalence of prediabetes was associated with male gender, frequent consumption of junk foods, decreased physical activities, overweight, obesity and high waist to hip ratio. Combination of FBS with GTT and FBS with HbA1c had better sensitivity and specificity when compared to combination of OGTT with HbA1c .
Conclusion: Screening of children for prediabetes at younger age especially those with risk factors and intervention with lifestyle modification may help in delaying the progression of the disease.
References
International Diabetes Federation (IDF) Diabetes atlas, 11th Edition. Available at: version:www.diabetesatlas.org. 2017
Bansal N. Prediabetes diagnosis and treatment: A review. World J Diabetes. 2015;6(2):296-303.
American Diabetes Association. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetesd. Diabetes Care. 2018;41(1):S13-S27.
World Health Organization, World Health Organization. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of a WHO/IDF consultation. Geneva: World Health Organization; 2006;1-50.
Taranikanti M, Panda S, Sukanya M, Swamy PN, Khan MS, Tabassum H, et al. Prediabetes in South Indian rural adolescent school students. Ind J Physiol Pharmacol. 2014;58(1):77-80.
Narayanappa D, Rajani HS, Mahendrappa KB, Prabhakar AK. Prevalence of prediabetes in school-going children. Ind pediatr. 2011 Apr ;48(4):295-9.
Krishnappa SK, Yashoda HT, Chaitra KM. Opportunistic screening of at risk asymptomatic adolescent children for prediabetes. Indian J Child Health. 2017;4(2):119-22.
Yajnik CS, Lubree HG, Rege SS, Naik SS, Deshpande JA, Deshpande SS et al. Adiposity and hyperinsulinemia in Indians are present at birth. J Clin Endocrinol Metab. 2002;87(12):5575-80.
Bavdekar A, Yajnik CS, Fall CH, Bapat S, Pandit AN, Deshpande V et al. Insulin resistance syndrome in 8-year-old Indian children: small at birth, big at 8 years, or both? Diabet. 1999;48(12):2422-9.
Pereira MA, Kartashov AI, Ebbeling CB, Van Horn L, Slattery ML, Jacobs DR Jr, et al. Fast food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet. 2005;365:36-42.
Duncan GE, Perri MG, Theriaque DW, Hutson AD, Eckel RH, Stacpole, PW. Exercise training, without weight loss, increases insulin sensitivity and post heparin plasma lipase activity in previously sedentary adults. Diabetes Care. 2003;26(3):557-62.
Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism linking diabetes mellitus and obesity. Diabetes Metab Syndr Obes. 2014 Dec 4;7:587-91.
Tandon N, Garg MK, Singh Y, Marwaha RK. Prevalence of metabolic syndrome among urban Indian adolescents and its relation with insulin resistance (HOMA-IR). J Pediatr Endocrinol Metab. 2013;26(11-12):1123-30.
Vikram NK, Misra A, Pandey RM, Luthra K, Wasir JS, Dhingra V. Heterogeneous phenotypes of insulin resistance and its implications for defining metabolic syndrome in Asian Indian adolescents. Atherosclerosis. 2006;186(1):193-9.
Goran MI, Ball GD, Cruz MI. Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. J Clin Endocrinol Metab. 2003 Apr 1;88(4):1417-27.
Misra A, Vikram NK, Arya S, Pandey RM, Dhingra V, Chatterjee A et al. High prevalence of insulin resistance in post pubertal Asian Indian children is associated with adverse truncal body fat patterning, abdominal adiposity and excess body fat. Int J Obes Relat Metab Disord. 2004;28(10):1217-26.
Ranjani H, Sonya J, Anjana RM, Mohan V. Prevalence of glucose intolerance among children and adolescents in urban South India (ORANGE-2). Diabetes Technol Ther. 2013;15(1):13-9.
