The prognosis for glycemic status among children and youth with obesity 2 years after entering a weight management program

Khalifah, Reem Al; Thabane, Lehana; Tarnopolsky, Mark A.; Morrison, Katherine M.

doi:10.1111/pedi.12675

Cited by 8 publications

(9 citation statements)

References 31 publications

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“…A recent publication of NHANES (1999–2016) found that 25.5% of US youth (10.6 million in 2016) would meet the screening criteria based upon the ADA guidelines 37 . In the NHANES study, in the screen‐eligible population, 4.1% had HbA1c‐defined (≥5.7%) hyperglycaemia, 16.0% had fasting Plasma Glucose‐defined (≥100 mg/dl) hyperglycaemia, whereas 17.9% had hyperglycaemia defined by either HbA1c or fasting plasma glucose, 37 these rates are much lower than when using OGTT criteria, as seen in our study (37.6%), and previously published studies 33–36 . Though HbA1c is a quicker and cheaper test, OGTT is more cost‐effective to screen for paediatric dysglycaemia, with 100% effectiveness (proportion of cases identified) and efficiency (cost/case identified) at $390/case, while HbA1c was the least effective (ranges, 7%–32% and $938–$3370/case) 38 .…”

Section: Discussionmentioning

confidence: 99%

“…33,34 This is similarly demonstrated in international populations where the estimated prevalence of dysglycaemia in youth with overweight/obesity was ~40% when screened by OGTT and HbA1c. 35,36 To date, there is limited evidence to guide screening for dysglycaemia based on the number of diabetes risk factors. Our data suggest that the presence of one risk factor besides overweight/obesity is sufficient to merit screening for dysglycaemia, supporting the ADA recommendation.…”

Section: Ogtt-derived Insulin Sensitivity and β-Cell Function And The...mentioning

confidence: 99%

“…37 In the NHANES study, in the screen-eligible population, 4.1% had HbA1c-defined (≥5.7%) hyperglycaemia, 16.0% had fasting Plasma Glucose-defined (≥100 mg/dl) hyperglycaemia, whereas 17.9% had hyperglycaemia defined by either HbA1c or fasting plasma glucose, 37 these rates are much lower than when using OGTT criteria, as seen in our study (37.6%), and previously published studies. [33][34][35][36] Though HbA1c is a quicker and cheaper test,…”

Section: Ogtt-derived Insulin Sensitivity and β-Cell Function And The...mentioning

confidence: 99%

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Youth prediabetes and type 2 diabetes: Risk factors and prevalence of dysglycaemia

et al. 2021

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Background: The American Diabetes Association recommends risk-based screening for dysglycaemia (prediabetes and type 2 diabetes) in youth with overweight/obesity plus ≥1 risk factor. However, evidence for these recommendations is lacking.Objectives: Examine the association between the number of risk factors and the prevalence of dysglycaemia in youth with overweight/obesity at initial presentation.Methods: In a paediatric obesity registry, youth (>10 and <20 years old, body mass index ≥85th percentile) were categorized into four groups according to number of risk factors (1, 2, 3 and ≥4). Based on oral glucose tolerance test, participants were classified into normal glucose tolerance or dysglycaemia.Results: Of 635 youth, 31.5% had prediabetes and 6.1% had type 2 diabetes. The prevalence of dysglycaemia was 23.1% with 1 risk factor and increased to 44.9% with ≥4 risk factors (p = 0.025). Dyslipidaemia, family history of type 2 diabetes and maternal history of gestational diabetes were significantly associated with dysglycaemia.Fasting and 2-h insulin, 2-h glucose increased (all p < 0.0001) and ALT increased (p = 0.001) with increasing risk factors. Insulin sensitivity and β-cell function deteriorated significantly with increasing risk factors. Conclusion:Screening for dysglycaemia in youth with obesity and any additional risk factor is warranted to target early management.impaired glucose tolerance, prediabetes, risk factors, youth-type 2 diabetes | INTRODUCTIONParallel to the increasing rates of childhood obesity, the incidence 1 and the prevalence 2 of youth-type 2 diabetes (T2D) is escalating worldwide, particularly in non-white racial/ethnic populations. The highest rate of youth-T2D exists in the United States, with an incidence that increased from 9 to 12.5 cases per 100 000 between 2002 and 2012. 1,3 While the trends in Europe and Asia are similar, the overall incidence remains lower. [4][5][6] Scientific information suggests that youth-T2D is an aggressive disease with early and rapidly progressing complications. [7][8][9] Youth with T2D have higher complications and mortality compared to peers with type 1 diabetes. 10,11 These youth also have a higher risk of early death than adults with T2D when matched for diabetes duration. 12 The treatment options for T2D in Adolescents and Youth (TODAY) showed >50% glycaemic failure rates on metformin, the only Abbreviations: ADA, American Diabetes Association; BMI, body mass index; GDM, gestational diabetes mellitus; HAPO FUS, Hyperglycaemia and Adverse Pregnancy Outcome Follow-up Study; HDL, high density lipoprotein; IFG, impaired fasting glucose; IGT, impaired glucose tolerance; ΔI 30 /ΔG 30 , insulinogenic index; 1/I F , inverse of fasting insulin; LDL, low density lipoprotein; oDI, oral disposition index; OGTT, oral glucose tolerance test; PCOS, polycystic ovary syndrome; SEM, standard error of the mean; SGA, small for gestational age; TC, total cholesterol; TG, triglycerides; TODAY, treatment options for type 2 diabetes in adolescents and youth; T2D, type 2...

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Section: Discussionmentioning

confidence: 99%

Section: Ogtt-derived Insulin Sensitivity and β-Cell Function And The...mentioning

confidence: 99%

Section: Ogtt-derived Insulin Sensitivity and β-Cell Function And The...mentioning

confidence: 99%

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Youth prediabetes and type 2 diabetes: Risk factors and prevalence of dysglycaemia

et al. 2021

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“…In children and adolescents, obesity is associated with high blood pressure and abnormal fasting glucose, dyslipidemia, obstructive sleep apnea, depression, and low quality of life in general. (7)(8)(9). In addition to chronic health diseases, obesity can result in increased mortality among adults (10,11).…”

Section: Introductionmentioning

confidence: 99%

Validation of the Family Health Behavior Scale for the Brazilian Population

Preto

Scarpatto

Ley

et al. 2020

Preprint

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Background: It is well known that the family environment is associated with child health behavior and outcomes. However, there is a lack of available instruments to measure family health behaviors, even more so in languages other than English. The aim of the present study was to adapt and validate the Family Health Behavior Scale (FHBS) for Brazilian families.Methods: The FHBS was translated and culturally adapted for the Brazilian families. Psychometric properties (content validity, construct validity, and concurrent validity) and reliability (internal consistency, ceiling-floor effect, and test-retest) were evaluated in a sample of healthy community-dwelling children who were between 5 to 12 years old, of both sexes. Caregivers responded to the FHBS. Concurrent validity was assessed by comparing the FHBS scale with Body Mass Index (BMI) percentile, percent body fat, and physical activity level.Results: 272 children (54% girls) with a mean age of 7.9 years (SD = 2.0) and their caregivers were tested. Confirmatory analysis of the initial 4-factor structure (as proposed in the original English version of the questionnaire) suggested its performance was below acceptable. Exploratory factor analysis showed however an acceptable fit (Kaiser-Meyer-Olkin index = 0.79), and the factor loadings suggested a 7-factor model. Children who were considered obese (BMI percentile ≥ 97) had lower mean total FHBS scores than children who had a healthy weight or were overweight. Children who were classified as having a healthy fat percentage had higher FHBS scores than children classified as having an excessively high fat percentage. Children who were physically active had significantly higher total FHBS scores than children who were physically inactive. Cronbach's alpha was 0.81 and we noted acceptable values of the ceiling-floor effect. Test-retest analyses showed lower agreement and intraclass correlation coefficients than expected 0.63 (95% CI 0.41 to 0.78).Conclusion: The adapted Family Health Behavior Scale for the Brazilian population showed adequate psychometric properties.

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“…In an article by Al Khalifah et al, the second affliation listed for Reem Al Khalifah was incorrect. Reem Al Khalifah is affiliated to the Department of Pediatrics, McMaster University, Hamilton, Canada and the Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia.…”

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confidence: 99%

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2020

Pediatr Diabetes

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The prognosis for glycemic status among children and youth with obesity 2 years after entering a weight management program

Abstract: Prediabetes presents significant morbidity in children with obesity. Family-based lifestyle interventions might delay prediabetes progression.

Cited by 8 publications

References 31 publications

Youth prediabetes and type 2 diabetes: Risk factors and prevalence of dysglycaemia

Youth prediabetes and type 2 diabetes: Risk factors and prevalence of dysglycaemia

Validation of the Family Health Behavior Scale for the Brazilian Population

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