How to screen obese children at risk for type 2 diabetes mellitus?

Marloes P van der Aa, Soulmaz Fazeli Farsani, Lisa A J Kromwijk, Anthonius de Boer, Catherijne A J Knibbe, Marja M J van der Vorst

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)337-342
Number of pages6
JournalClinical Pediatrics
Volume53
Issue number4
DOIs
Publication statusPublished - Apr 2014

Keywords

  • Blood Glucose
  • Child
  • Diabetes Mellitus, Type 2
  • Fasting
  • Female
  • Glucose Intolerance
  • Humans
  • Insulin Resistance
  • Male
  • Netherlands
  • Obesity
  • Retrospective Studies

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