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Screening for type 2 diabetes in obese youth

Shuchi Shah1, Bassil M Kublaoui, Jon D Oden

  • 1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9063, USA.

Pediatrics
|July 22, 2009
PubMed

Insights

Hemoglobin A1c (HbA1c) and 1,5-anhydroglucitol are effective blood tests for screening type 2 diabetes mellitus (T2DM) in obese children. Fasting blood glucose also shows promise, while HOMA-IR is less effective for T2DM prediction.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diagnostic Screening

Background:

  • Obesity in children is a growing concern, increasing the risk of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM).
  • Early detection of IGT and T2DM in obese children is crucial for timely intervention and management.
  • Identifying reliable and accessible screening tools is essential for pediatric metabolic health surveillance.

Purpose of the Study:

  • To evaluate the efficacy of various blood tests as screening tools for IGT and T2DM in obese children.
  • To compare the predictive performance of fasting glucose, hemoglobin A1c (HbA1c), 1,5-anhydroglucitol, and HOMA-IR for identifying dysglycemia.

Main Methods:

  • A cohort of 468 obese children underwent oral glucose-tolerance testing.
  • Fasting blood samples were analyzed for glucose, insulin, HbA1c, and 1,5-anhydroglucitol (in an insulin-resistant subgroup).
  • Receiver operator characteristic (ROC) curves were used to assess the screening efficacy of different biomarkers.

Main Results:

  • In the insulin-resistant subgroup, HbA1c (>or= 6.0%) and 1,5-anhydroglucitol (< 17.0 microg/mL) demonstrated high sensitivity and specificity for T2DM detection.
  • In the entire cohort, HbA1c (5.7%) and fasting blood glucose (104 mg/dL) showed good predictive values for T2DM.
  • HOMA-IR exhibited lower sensitivity and specificity compared to HbA1c and fasting glucose.

Conclusions:

  • HbA1c, 1,5-anhydroglucitol, and fasting blood glucose are valuable predictors for T2DM in obese children.
  • HOMA-IR is not a reliable screening tool for T2DM in this population.
  • HbA1c and 1,5-anhydroglucitol are particularly effective for screening T2DM in insulin-resistant obese children.
Abstract

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