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Pre-diabetes in Italian obese children and youngsters

C Brufani1, D Fintini, P Ciampalini

  • 1University Department of Paediatric Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. cbrufani@libero.it

Journal of Endocrinological Investigation
|June 14, 2011
PubMed

Insights

Obese children with pre-diabetes show varying insulin resistance. Impaired glucose tolerance (IGT) indicates peripheral issues, while combined impaired fasting glucose (IFG) and IGT signal severe whole-body insulin sensitivity defects.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Syndrome
  • Diabetes Research

Background:

  • Limited data exists on metabolic profiles and Type 2 Diabetes (T2D) progression in low-risk European obese children.
  • Understanding pre-diabetes variations in this demographic is crucial for early intervention.

Purpose of the Study:

  • To investigate differences in insulin sensitivity and secretion among Italian obese children and adolescents with pre-diabetes.
  • To compare metabolic characteristics between pre-diabetic states (IFG, IGT, IFG-IGT) and normal glucose tolerance (NGT).

Main Methods:

  • Ninety-six obese children and adolescents with pre-diabetes were pair-matched with NGT controls.
  • Oral glucose tolerance tests were used for screening; pre-diabetes classified as IFG, IGT, or combined IFG-IGT.
  • Calculated indices included HOMA-IR, 2-h insulin, ISI, and DI to assess insulin resistance and pancreatic function.

Main Results:

  • The IFG-IGT group exhibited the lowest insulin sensitivity index (ISI) and a severely reduced disposition index (DI).
  • Individuals with IFG showed the highest HOMA-IR (fasting insulin resistance), while IGT subjects had the highest 2-h insulin (peripheral resistance).
  • Compared to NGT, DI was significantly lower (60%) in the IFG-IGT group, indicating impaired pancreatic compensation.

Conclusions:

  • Impaired fasting glucose (IFG) is associated with fasting insulin resistance, while impaired glucose tolerance (IGT) relates to peripheral insulin resistance.
  • Combined IFG-IGT presents with reduced whole-body insulin sensitivity and a significant defect in pancreatic beta-cell function (DI).
  • Further longitudinal studies are necessary to confirm if these distinct pre-diabetes categories in obese European adolescents represent true, distinct pre-diabetic alterations.
Abstract

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