How Should we Screen Overweight and Obese Adolescents for Risk of Type 2 Diabetes in Large Public Health Initiatives?

Abstract

Decline in the biological response to insulin in the presence of normal or high blood concentrations of the hormone is called insulin resistance (IR) [1]. This could be reflective of an insensitivity of peripheral tissues (e.g., muscle, liver, adipose tissue) to the effects of insulin [2] or due to reduction in the maximal response to the hormone [1]. Obesity in adults is linked to IR. In 2011-2012, the US prevalence of overweight/obese children 12-19 years old of all races was 34.5% [3]. Excess weight in youth is a strong predictor of excess weight in adulthood [4,5]. It also is associated with an increased risk of cardiovascular disease and type 2 diabetes [6,7] and a greater likelihood of mortality from those conditions [8]. Furthermore, even among individuals with normal Abstract Purpose: To develop a valid method to identify insulin resistance (IR) in overweight and obese adolescents without requiring a fasting blood sample.