How to screen obese children at risk for type 2 diabetes mellitus?
BACKGROUND
Recommended screening to identify children at risk for diabetes and its precursors impaired glucose tolerance (IGT) and insulin resistance (IR) is fasted plasma glucose (FPG). This study evaluates the added value of fasted plasma insulin (FPI).


METHODS
This study analyzed routinely collected data of an oral glucose tolerance test (OGTT) of 311 obese children (age 10.8 ± 3.2 years). Diabetes and IGT were defined according to the American Diabetes Association criteria, IR as homeostasis model assessment (HOMA)-IR ≥3.4.


RESULTS
Cases diagnosed with an OGTT if FPG ≥5.6 mmol/L, compared with an OGTT performed if FPG ≥5.6 mmol/L or HOMA-IR ≥3.4, were, respectively, 4 (80%) versus 5 (100%) with diabetes, 7 (28%) versus 16 (64%) with IGT, and 0 (0%) versus 93 (100%) with IR.


CONCLUSIONS
Screening with FPG and FPI has equal burden compared with screening with FPG alone, identifies all patients with diabetes, and identifies more patients with precursors of diabetes.
1St. Antonius Hospital, Nieuwegein, Netherlands.
Marloes P
MP
van der Aa
Soulmaz
S
Fazeli Farsani
Lisa A J
LA
Kromwijk
Anthonius
A
de Boer
Catherijne A J
CA
Knibbe
Marja M J
MM
van der Vorst
D001786:Blood Glucose; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D005215:Fasting / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000097:blood; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D009426:Netherlands; D009765:Obesity / Q000097:blood / Q000150:complications*; D012189:Retrospective Studies
D001786:Blood Glucose
diabetes mellitus; insulin; obesity; screening