Frequency of abnormal carbohydrate metabolism and diabetes in a population-based screening of adolescents.
OBJECTIVE
To document the frequency of glucose intolerance in adolescents in a population-based study of primarily African-American/Non-Hispanic whites in an urban-suburban school district.


METHODS
Measurement of fasting and 2-hour post-glucose load plasma glucose concentrations.


RESULTS
Carbohydrate intolerance (either impaired fasting glucose, impaired glucose tolerance, or both) was identified in 8.0%, near-diabetes (1 fasting glucose > or = 126 mg/dL [7.0 mmol/L] and/or 2-hour glucose > or = 200 mg/dL [11.1 mmol/L]) in 0.3%, and diabetes in 0.36% (type 1A = 0.24%; type 2 = 0.08%; undiagnosed type 2 = 0.04%). A model for abnormal carbohydrate metabolism was constructed with regression analysis in the Carbohydrate Intolerance (CI)/near-diabetes group and with logistic regression in the entire study population. Risk factors for the development of CI/near-diabetes included having a 1 unit increase in body mass index (BMI) z-score and either being non-Hispanic white or in the pubertal group. Increased fasting glucose correlated with having puberty and decreased BMI z-score, whereas 2-hour glucose correlated with increased BMI z-score. By using National Health and Nutrition Survey (NHANES) III (1988-1994) definitions, impaired fasting glucose was present in 2.0% in this study versus 1.7% (NHANES III).


CONCLUSIONS
The prevalence of CI/near-diabetes was 8.3%. Undiagnosed diabetes mellitus was rare. One third of adolescents with diabetes mellitus could be classified as having type 2 diabetes mellitus. The adult model of the progression of insulin resistance to type 2 diabetes mellitus in adolescents may be valid. Despite the increase in the overweight population since NHANES III, abnormalities in glucose metabolism have not changed significantly.
Dolan
Lawrence M
LM
Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. Larry.Dolan@chmcc.org
Bean
Judy
J
D'Alessio
David
D
Cohen
Robert M
RM
Morrison
John A
JA
Goodman
Elizabeth
E
Daniels
Stephen R
SR
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004040:Dietary Carbohydrates / Q000378:metabolism*; D005215:Fasting; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D009820:Ohio / Q000453:epidemiology; D011446:Prospective Studies; D011627:Puberty; D044469:Racial Groups; D012044:Regression Analysis; D012307:Risk Factors; D013383:Suburban Population; D014505:Urban Population
D001786:Blood Glucose; D004040:Dietary Carbohydrates