Impaired glucose tolerance and type 2 diabetes mellitus: a new field for pediatrics in Europe.
OBJECTIVE
Several studies have shown that obese children and adolescence seem to have an increased risk to develop a disturbed glucose metabolism as already known for obese adults. This might result in the same disastrous outcomes of cardiovascular diseases as it has been shown for adult obese patients. The most sensitive measurement for detecting changes in glucose metabolism in obese children seems to be an oral glucose tolerance test (OGGT) which is not practical for all daily outpatient clinics.


METHODS
Cross-sectional study.


METHODS
We therefore made a preselection from a cohort of 491 subjects according to the American Diabetes Association (ADA) criteria for the diagnosis of diabetes. In the selected high-risk subgroup (n = 102) of obese pediatric subjects, we measured the prevalence of impaired glucose tolerance (IGT) by OGTT.


RESULTS
We diagnosed six patients with type 2 diabetes and 37 patients with impaired glucose tolerance. In addition, we found a close correlation of IGT to disturbances of triglyceride and cholesterol parameters. This prevalence was comparable to a similar study group that was screened without preselection.


CONCLUSIONS
These prevalence data further underline the need to diagnose children with obesity-associated risk factors in terms of an insulin resistance syndrome. The preselection of a high-risk subgroup by ADA criteria might be a practical approach.
Wiegand
S
S
Paediatric Endocrinology, Charité Children's Hospital, Humboldt University, Berlin, Germany. susanna.wiegand@chartie.de
Dannemann
A
A
Krude
H
H
Grüters
Annette
A
D000293:Adolescent; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000378:metabolism; D002648:Child; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D018579:Patient Selection; D015995:Prevalence; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol