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.
Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. Larry.Dolan@chmcc.org
Lawrence M
LM
Dolan
Judy
J
Bean
David
D
D'Alessio
Robert M
RM
Cohen
John A
JA
Morrison
Elizabeth
E
Goodman
Stephen R
SR
Daniels
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