title: Generational change in fasting glucose and insulin among children at ages 5-16y: Modelled on the EarlyBird study (2015) and UK growth standards (1990) (EarlyBird 69).
abstract: OBJECTIVE
  Pre-diabetes is a state of beta-cell stress caused by excess demand for insulin. Body mass is an important determinant of insulin demand, and BMI has risen substantially over recent time. We sought to model changes in the parameters of glucose control against rising BMI over the past 25years.
  
  
  METHODS
  Using random coefficient mixed models, we established the correlations between HbA1C, fasting glucose, fasting insulin, HOMA2-IR and BMI in contemporary (2015) children (N=307) at ages 5-16y from the EarlyBird study, and modelled their corresponding values 25years ago according to the distribution of BMI in the UK Growth Standards (1990).
  
  
  RESULTS
  There was little change in HbA1C or fasting glucose over the 25y period at any age or in either gender. On the other hand, the estimates for fasting insulin and HOMA2-IR were substantially higher in both genders in 2015 compared with 1990.
  
  
  CONCLUSIONS
  Insofar as it is determined by body mass, there has been a substantial rise in beta cell demand among children over the past 25years. The change could be detected by fasting insulin and HOMA2-IR, but not by fasting glucose or HbA1C.
authors.affiliation: Institute of Health Research, University of Exeter Medical School, Exeter, UK; College of Life and Environmental Sciences (CLES), University of Exeter, Exeter, UK. Electronic address: m.mostazir@exeter.ac.uk.
authors.forename: Mohammod
authors.initials: M
authors.lastname: Mostazir
authors.affiliation: Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Jeffery
authors.affiliation: Institute of Health Research, University of Exeter Medical School, Exeter, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Voss
authors.affiliation: Institute of Health Research, University of Exeter Medical School, Exeter, UK.
authors.forename: Terence
authors.initials: T
authors.lastname: Wilkin
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015988:Cohort Effect; D005215:Fasting / Q000097:blood*; D005260:Female; D005951:Glucose Tolerance Test; D057238:Growth Charts; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D008962:Models, Theoretical; D011236:Prediabetic State / Q000097:blood / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Fasting glucose; Generational change; Insulin