Insulin function in obese children within the low and high ranges of impaired fasting glycemia

Area of Science:

• Pediatric Endocrinology
• Metabolic Disorders
• Obesity Research

Background:

• Impaired fasting glycemia (IFG) signifies intermediate hyperglycemia, but its impact on insulin-glucose homeostasis in obese children remains unclear.
• Understanding these variations is crucial for early detection and intervention in pediatric metabolic health.

Purpose of the Study:

• To investigate insulin and glucose homeostasis across different fasting glucose levels within the non-diabetic range in Swedish children and adolescents with obesity.
• To determine the specific fasting glucose thresholds associated with impaired metabolic function in this population.

Main Methods:

• Utilized an insulin-modified frequent sample intravenous glucose tolerance test (GTT) in 333 obese children and adolescents.
• Assessed acute insulin response (AIR), insulin sensitivity (SI), and disposition index (DI).
• Categorized participants into three groups based on fasting glucose: normoglycemic (≤5.5 mmol/L), ADA's IFG range (5.6-6.0 mmol/L), and WHO's IFG range (6.1-6.9 mmol/L).

Main Results:

• Fasting glucose levels between 5.6-6.0 mmol/L showed no significant difference in AIR, SI, or DI compared to the normoglycemic group.
• Fasting glucose levels between 6.1-6.9 mmol/L were associated with significantly lower AIR and DI, though SI remained statistically similar.
• IFG within the American Diabetes Association's exclusive range (5.6-6.0 mmol/L) did not correlate with disturbed glucose metabolism.

Conclusions:

• IFG as defined by the ADA (5.6-6.0 mmol/L) in obese children does not appear to be associated with impaired glucose metabolism.
• Higher fasting glucose levels (6.1-6.9 mmol/L) indicate a more significant impact on insulin secretion and overall glucose regulation.
• These findings suggest that IFG may affect metabolic profiles in obese children differently than previously observed in adult populations.