[Risk-stratified screening for diabetes in adolescents: results of the first investigation in Hungary].
The prevalence of type 2 diabetes mellitus in children and adolescents is increasing throughout the world. Early detection of blood glucose abnormalities is essential to improve long term prognosis of type 2 diabetes, as intervention strategies could be the most effective in youngsters.


OBJECTIVE
To assess the prevalence of blood glucose abnormalities in asymptomatic adolescents having increased risk of diabetes, a screening program of the Hungarian Diabetes Association has been carried out in pediatric primary care setting.


METHODS
660 adolescents aged 12-18 years recruited from general pediatric practices were involved in the study. Risk assessment was performed by a questionnaire compiled according to the ADA recommendation for testing type 2 diabetes in childhood. Fasting plasma glucose and OGTT were performed in adolescents having increased risk for type 2 diabetes (overweight plus two additional clinical risk factors) and results were assessed according to WHO criteria.


RESULTS
285 adolescents of 660 were selected with increased risk for type 2 diabetes established by questionnaire (age: 15.2±1.8 years, BMI: 30.2±4.2 kg/m 2 , 141 males). Among subjects with increased risk, 16 (5.6%) had any type of blood glucose abnormalities: 4 (1.40%) IFG, 5 (1.75%) IFG+IGT, 6 (2.11%) IGT and 1 (0.35%) type 2 diabetes. Assessing the effect of clinical variables, increased BMI proved to be the strongest predictor of the diabetes risk [OR (95% CI): 1.216 (1.174-1.258), p<0.0001].


CONCLUSIONS
Screening procedure among asymptomatic adolescents with high risk of type 2 diabetes in the general pediatric practice is a simple and effective method for early detection of blood glucose abnormalities. Screening for type 2 diabetes in adolescents at risk should be encouraged in Hungary, and should be performed in pediatric primary care setting.
Barkai
László
L
Orvos- és Egészségtudományi Centrum Gyermekegészségügyi Továbbképző Intézet Miskolc Szentpéteri kapu 76. 3501 Miskolci Egyetem. Barkai.L@t-online.hu
Madácsy
László
L
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires
D001786:Blood Glucose