Background: Despite the epidemic of pediatric obesity, the prevalence of type 2 diabetes (T2D) during childhood remains low. Although obesity in youth portends cardiometabolic disease later in life, longitudinal data describing the progression of T2D into young adulthood are scarce.
Methods: We evaluated glycemic status (normal, prediabetes, or T2D) in a cohort of Latino youth with obesity (n=396; age 14.5±1.4; 55.6% male, BMI 33.9±5.3), and in a sub-set of participants who were re-engaged as young adults (n=39; age 20.8±1.0; 38.5% male, BMI 41.7±8.1). Glycemic status was determined from an oral glucose tolerance test with hyperglycemia classified according to ADA criteria.
Results: Among adolescents, the prevalence rates for normal, prediabetes, and T2D were 69.9%, 28.1%, and 1.3% respectively; while prevalence rates in young adults after a 5-year follow-up period were 64.1%, 25.6%, and 10.3%, respectively. Of the adolescents with normal glucose status at baseline who returned as young adults (n=28), 5 (17.9%) developed prediabetes, and 1 (3.6%) developed T2D. Of those with prediabetes at baseline (n=11), 4 (36.4%) reverted to normal glucose status, 4 (36.4%) remained prediabetic, and 3 (27.3%) developed T2D. Young adults with T2D were more likely to have a parental history of T2D than those who did not develop T2D (50% vs. 11%, p=0.04).
Conclusion: Despite strong risk factors, the prevalence of T2D among a cohort of Latino adolescents with obesity was low (1.3%). Of those who had normal glucose status during adolescence, the prevalence rate of T2D after a 5-year follow-up period was similarly low (3.6%), while for those with prediabetes during adolescence, the prevalence rate of T2D at follow-up was substantially higher (27.3%). Stratifying obese youth by glycemic status significantly affects the long-term prediction of developing T2D, which may have important implications for medical-decision making and resource allocation when managing youth with multiple T2D risk factors.
M. Olson: None. Y.P. Konopken: None. C. Keller: None. D.L. Patrick: None. A. Williams: None. S. Ayers: None. W.C. Knowler: None. A. Pena: None. E.G. Soltero: None. G.Q. Shaibi: None.
National Institute on Minority Health and Health Disparities (P20MD002316, U54MD002316); National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK107579)