Obese Kids at Risk for Diabetes

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March 13, 2002 -- Previous research has shown that the number of overweight kids in the U.S. is approaching 20%. Now a new study reveals that one in four obese children has early signs of type 2 diabetes -- a type seen only in adults until recently.

In fact, almost half of the children and adolescents now diagnosed with diabetes have the type 2 form of the disease, which is strongly linked to obesity and lack of exercise.

In the Yale University study, published in the March 14 issue of The New England Journal of Medicine, researchers looked at 167 kids and teens. They had a body mass index -- or BMI -- greater than the 95th percentile for their age. To calculate your child's BMI, look in Related Links. Your pediatrician will have charts to determine what percentile your child falls into.

The researchers tested the kids for evidence of impaired glucose tolerance. Impaired glucose tolerance means that the body is not able to use sugar properly and the sugar levels in the blood go higher than normal after eating -- but not yet high enough to be considered diabetes.

Of kids aged 4-10, 25% had impaired glucose tolerance -- an indication that diabetes might not be too far away. Of those aged 11-18, 21% had impaired glucose tolerance. And 4% of the obese adolescents already had type 2 diabetes that neither they nor the parents were aware of.

In adults, as many as one in 10 people with impaired glucose tolerance will go on to develop diabetes.

"We were quite surprised to find that the prevalence of impaired glucose tolerance was very high in these children, even higher than has been reported in obese adults," senior researcher Sonia Caprio, MD, tells WebMD. "This shows very clearly that these children are at risk, and that they should be watched closely."

Figures released late last year confirmed that childhood obesity has reached epidemic proportions in the U.S. Between 1986 and 1998, the number of non-Hispanic white children who were overweight doubled from 6% to 12%, and roughly 20% of black and Hispanic children are now overweight.

The findings are disheartening, says pediatric cardiologist Alpert P. Rocchini, MD, because they point to an emerging epidemic of type 2 diabetes among children and adolescents. But he adds that testing also offers hope of identifying those obese young people who are at the greatest risk for developing the disease.

"Although it is possible to treat obesity [in children], it is extremely difficult and requires both extensive resources and a very highly motivated child and family," he writes in an editorial accompanying the study. "Even with successful weight loss, the rate of relapse is high. I believe that a more effective strategy is to identify those obese children who are at high risk for diabetes and to target them for intensive weight-loss treatment."

"These results strongly imply that intensive efforts to reduce obesity in children and youth who have impaired glucose tolerance will help to prevent their developing type 2 diabetes, says Duane Alexander, MD, director of the National Institute of Child Health and Human Development, which funded the study.

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