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Diabetes Type 2 in Neurologically Impaired Children and Adolescents Without Obesity: A New Emerging Entity?

Valeria Calcaterra1,2, Hellas Cena3,4, Annalisa De Silvestri5

  • 1Pediatric and Adolescence Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy.

Frontiers in Neurology
|September 27, 2019
PubMed

Insights

Neurologically impaired children show a high prevalence of insulin resistance (IR) and type 2 diabetes (T2D). Early screening using IR markers is recommended for this at-risk population to prevent diabetes.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Disorders

Background:

  • Insulin resistance (IR) is a key factor in type 2 diabetes (T2D) development.
  • Neurologically impaired (NI) children often present with unfavorable cardio-metabolic profiles and high IR rates.

Purpose of the Study:

  • To evaluate the prevalence of T2D in NI children and adolescents.
  • To determine if dedicated glucose monitoring is advisable for this population.

Main Methods:

  • Retrospective evaluation of 63 severely disabled children and adolescents (mean age 11.4 years).
  • Assessment of auxological parameters, fasting blood glucose (FBG), fasting insulin, and triglycerides (TG).
  • IR detection using homeostasis model assessment for insulin resistance (HOMA-IR) and triglyceride-glucose index (TyG index).

Main Results:

  • Prevalence of impaired insulin sensitivity, pathological TyG index, and elevated FBG were 41.3%, 63.5%, and 11.1%, respectively.
  • T2D was diagnosed in 3.2% of asymptomatic patients.
  • Diabetes prevalence was significantly higher in pre-pubertal compared to pubertal subjects (p=0.03).

Conclusions:

  • Type 2 diabetes in NI children and adolescents, even without obesity, may be an emerging health concern.
  • IR and its surrogate markers are valuable tools for primary screening in this high-risk disabled population.
  • Screening can aid in the prevention of diabetes among neurologically impaired youth.

Keywords:
adolescentschildrendisabilityneurologically impairedtype 2 diabetes

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