title: Successful strategy to improve glucose tolerance in Thai obese youth.
abstract: BACKGROUND
  Childhood obesity is an emerging national health problem in Thailand. Our previous study found that one third of obese children and adolescents had impaired glucose tolerance (IGT) and 2.6 percent had already developed type 2 diabetes mellitus. An immediate strategy needs to be established in order to improve these metabolic problems.
  
  
  OBJECTIVE
  To determine whether diet and exercise education for lifestyle modification with or without metformin therapy in our diabetes clinic is enable to improve these metabolic problems.
  
  
  METHODS
  Twenty-six Thai obese children and adolescents with IGT, who received at least 6 months of treatment consisting of lifestyle modification alone or lifestyle modification and metformin (combined treatment) were enrolled into this study. Each patient underwent the second 2-hour oral glucose tolerance test (OGTT). Plasma glucose, insulin levels, HbA1C and lipid profiles were measured. The results were compared with historical pre-treatment data.
  
  
  RESULTS
  Approximately 1 year after intervention, 19 out of 26 patients with IGT completed the second 2-hour OGTT. Sixteen patients (84.2%) successfully reversed to be normal glucose tolerance whereas 3 patients (15.8%) remained IGT. Body mass index (BMI), BMISDS, 2-hour plasma glucose, basal insulin level, 2-hour insulin level were significantly decreased after treatment in normal OGTT group (Ps < 0.05). Treatment with lifestyle modification alone and combined treatment indifferently improved the abnormal glucose tolerance in our patient (83.3% vs. 84.6%).
  
  
  CONCLUSIONS
  Impaired glucose tolerance in obese youth is a reversible abnormality by lifestyle modification with or without metformin.
authors.affiliation: Division of Endocrinology Diabetes and Metabolism, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. nawapornsom@gmail.com
authors.forename: Nawaporn
authors.initials: N
authors.lastname: Numbenjapon
authors.forename: Pairunyar
authors.initials: P
authors.lastname: Nakavachara
authors.forename: Jeerunda
authors.initials: J
authors.lastname: Santiprabhob
authors.forename: Pornpimol
authors.initials: P
authors.lastname: Kiattisakthavee
authors.forename: Renu
authors.initials: R
authors.lastname: Wongarn
authors.forename: Supawadee
authors.initials: S
authors.lastname: Likitmaskul
mesh_terms: D000293:Adolescent; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000097:blood; D008019:Life Style; D008297:Male; D008687:Metformin / Q000008:administration & dosage*; D009765:Obesity / Q000097:blood / Q000378:metabolism* / Q000628:therapy; D010353:Patient Education as Topic; D013785:Thailand / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin