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Insulin resistance in children: consensus, perspective, and future directions
Claire Levy-Marchal1, Silva Arslanian, Wayne Cutfield
1Institut National de la Santé et de la Recherche Médicale, Unité 690, Hôpital Robert Debré, Université Paris Diderot, 75013 Paris, France.
The Journal of Clinical Endocrinology and Metabolism
|September 11, 2010
Summary
Insulin resistance in children is a growing concern linked to cardiometabolic risk. Current screening methods lack justification, but lifestyle changes can improve insulin sensitivity.
Area of Science:
- Pediatric Endocrinology
- Metabolic Health
- Childhood Obesity
Background:
- Insulin resistance is increasingly prevalent in children and adolescents.
- It is associated with significant cardiometabolic risk factors.
- Current understanding and management strategies require clarification.
Framework:
- A consensus conference addressed key issues in pediatric insulin resistance.
- Working groups focused on definition, measurement, risk factors, prevention, and treatment.
- International scientific societies provided support and expertise.
Implementation:
- Literature reviews informed group discussions and document finalization.
- A systematic search identified relevant articles on pediatric insulin resistance.
- Debates and agreements were reached during a 3-day meeting.
Implications:
- Clear diagnostic criteria for pediatric insulin resistance are lacking.
- Surrogate markers like fasting insulin are unreliable for assessing insulin sensitivity.
- Screening children for insulin resistance is not currently recommended.
- Lifestyle interventions (diet, exercise) are effective for improving insulin sensitivity.
- Pharmacological treatment should be reserved for select cases.
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