title: Evidence of early beta-cell deficiency among children who show impaired fasting glucose: 10-yr cohort study (EarlyBird 56).
abstract: OBJECTIVE
  Impaired fasting glucose (IFG) is a predictor of future diabetes and is increasingly common in children, but the extent to which it results from excess insulin demand or failure of supply is unclear. Our aim was to compare the behaviour of insulin sensitivity and beta-cell function in children who developed IFG with those whose glucose levels remained within the normal range.
  
  
  METHODS
  We examined trends in fasting glucose, insulin sensitivity (HOMA-S) and beta-cell function (HOMA-B) in 327 healthy children annually from 5 to 15 yr, and the parents at baseline.
  
  
  RESULTS
  Fifty-five children showed IFG, mostly after age 11 yr. Fasting glucose rose progressively and was higher throughout in those who developed IFG compared with those who did not (p < 0.001). Beta-cell function was lower from the age of 5 yr in those who developed IFG (p = 0.006), but there was no difference in BMI (p = 0.71). A difference in insulin sensitivity was revealed on adjustment for covariates (p = 0.03). Glucose was higher (p < 0.001), beta-cell function lower (p = 0.01), and insulin sensitivity the same (p = 0.86) in the mothers of children who showed IFG, compared with those who did not.
  
  
  CONCLUSIONS
  IFG is common in contemporary children, and appears to be related to a defect in beta-cell function already present at 5 yr. Similar findings in the mothers of IFG children suggest that the beta-cell defect may be transmissible.
authors.affiliation: University Medicine, Level 07 Derriford Hospital, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Hosking
authors.forename: Brad S
authors.initials: BS
authors.lastname: Metcalf
authors.forename: Alison N
authors.initials: AN
authors.lastname: Jeffery
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Streeter
authors.forename: Linda D
authors.initials: LD
authors.lastname: Voss
authors.forename: Terence J
authors.initials: TJ
authors.lastname: Wilkin
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005215:Fasting; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000502:physiology*; D008297:Male; D009035:Mothers; D011236:Prediabetic State / Q000503:physiopathology
chemical_list: D001786:Blood Glucose
keywords: IFG; beta-cell function