Diabetes mellitus tipo 2 e intolerancia a la glucosa en niños y adolescentes con obesidad: ¿una epidemia moderna? / Frequency of diabetes mellitus and glucose intolerance among obese children and adolescents

ABSTRACT

Background: The prevalence obesity, type 2 diabetes (DM2) and glucose intolerance among children is increasing worldwide. Aim: To assess the frequency of DM2 and GI among severely obese children and adolescents. Patients and methods: Cross sectional study of 69 children and adolescents aged 12 +/- 3 years with a mean body mass index (BMI) z score of 2.9 +/- 0.6. An oral glucose tolerance test (OGTT) was performed, measuring fasting and 120 minutes blood glucose and insulin. According to these results two patients had diabetes mellitus and 4 had glucose intolerance. Previously studied patients, five with diabetes mellitus and two with glucose intolerance were incorporated to the present study. These 13 participants were compared with the remaining 63 children without abnormalities in glucose metabolism, considered as controls. Results: Body mass index among children with glucose intolerance, diabetes mellitus and controls was 33.8 +/- 6.4, 26.7 +/- 5.1 and 29.4 +/- 4.5 kg/m2, respectively, p = 0.03. Basal and 120 min insulin levels were also significantly higher among children with glucose intolerance compared with diabetics and controls. Homeostasis model assessment for insulin resistance was significantly lower in controls than in children with diabetes or glucose intolerance. Conclusions: Eight percent of this group of obese children and adolescents had DM2 or glucose intolerance. Oral glucose tolerance test should be included in the routine assessment of obese children to diagnose abnormalities of glucose metabolism.