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The incidence of Y-T2DM is increasing parallel with the childhood obesity epidemic. The ADA consensus recommends screening for Y-T2DM or prediabetes in asymptomatic overweight youth who have any two additional risk factors (RFs): family history of T2DM in 1st or 2nd degree relatives, minority race/ethnicity, insulin resistance [acanthosis nigricans, polycystic ovary syndrome, hypertension, dyslipidemia, and small for gestational age], and maternal GDM during the child’s gestation. However, the evidence for these recommendations is minimal, if not nonexistent. In an established pediatric obesity registry, OGTT data of 618 youth ˃10 years old, BMI ≥ 85th%, were analyzed to evaluate the prevalence of DG based on the frequency of RFs. Participants were divided into 4 groups according to the number of RFs. Participants were 70% females, 70% Caucasians, 31% with prediabetes, and 5.1% with Y-T2DM. With increasing RFs, the prevalence of normal glucose tolerance (NGT) declined, DG increased, fasting glucose concentration did not change, but fasting insulin concentration increased significantly (Table: mean ± SE). Participants with 1 RF had ∼25% prevalence of DG. The odds for DG with 2, 3 and ≥ 4RFs were 1.6, 1.7, and 2.5 respectively compared to 1 RF (P=0.01).

In conclusion, the prevalence of prediabetes and T2DM in overweight/obese youth is high ∼25% in the presence of only 1 RF, and escalates with increasing number of RFs.

 Obesity + 1 RF (n=45) Obesity + 2 RF (n=165) Obesity + 3 RF (n=223) Obesity + ≥4RF (n=185) P-ANOVA 
Age (years) 13.7 ± 0.3 14.0 ± 0.2 14.3 ± 0.1 14.4 ± 0.2 NS 
Glycemic status (NGT/Dysglycemia), n (%) 34 (75.6 %) / 11 (24.4 %) 1(65.5 %) / 57 (34.5 %) 143 (64.1 %) / 80 (35.9 %) 103 (55.7 %) / 82 (44.3 %) 0.009 
BMI percentile 97.6 ± 0.4 98.0 ± 0.3 98.4 ± 0.2 98.6 ± 0.2 NS 
Fasting glucose (mg/dl) 92.4 ± 1.2 93.9 ± 0.9 94.0 ± 0.9 94.9 ± 1.2 NS 
Fasting insulin (μu/ml) 25.6 ± 2.3 31.0 ± 1.9 34.7 ± 1.6 42.5 ± 2.7 < 0.0001 
OGTT 2-hr. Glucose (mg/dl) 117.6 ± 4.7 125.9 ± 3.0 129.4 ± 2.7 138.4 ± 3.3 0.001 
OGTT 2-hr. Insulin (μU/ml) 121.5 ± 17.6 160.7 ± 11.2 169.9 ± 10.8 217.0 ± 14.3 < 0.0001 
 Obesity + 1 RF (n=45) Obesity + 2 RF (n=165) Obesity + 3 RF (n=223) Obesity + ≥4RF (n=185) P-ANOVA 
Age (years) 13.7 ± 0.3 14.0 ± 0.2 14.3 ± 0.1 14.4 ± 0.2 NS 
Glycemic status (NGT/Dysglycemia), n (%) 34 (75.6 %) / 11 (24.4 %) 1(65.5 %) / 57 (34.5 %) 143 (64.1 %) / 80 (35.9 %) 103 (55.7 %) / 82 (44.3 %) 0.009 
BMI percentile 97.6 ± 0.4 98.0 ± 0.3 98.4 ± 0.2 98.6 ± 0.2 NS 
Fasting glucose (mg/dl) 92.4 ± 1.2 93.9 ± 0.9 94.0 ± 0.9 94.9 ± 1.2 NS 
Fasting insulin (μu/ml) 25.6 ± 2.3 31.0 ± 1.9 34.7 ± 1.6 42.5 ± 2.7 < 0.0001 
OGTT 2-hr. Glucose (mg/dl) 117.6 ± 4.7 125.9 ± 3.0 129.4 ± 2.7 138.4 ± 3.3 0.001 
OGTT 2-hr. Insulin (μU/ml) 121.5 ± 17.6 160.7 ± 11.2 169.9 ± 10.8 217.0 ± 14.3 < 0.0001 

Disclosure

M. Saleh: None. J. Kim: None. C. March: None. S. Yousuf: None. S.A. Arslanian: None.

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