Type 2 diabetes mellitus and impaired glucose regulation in overweight and obese children and adolescents living in Serbia

Abstract

An increase in the prevalence of pediatric type 2 diabetes mellitus (T2DM) has been reported by numerous studies in the United States during the past two decades. Available data from Europe are scarce, but also suggest the rising prevalence of this disease in overweight children. The aim of this study was to determine the prevalence of previously undiagnosed T2DM, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) in a clinic cohort of otherwise healthy overweight and obese Caucasian children and adolescents living in Serbia. The study group consisted of 301 subjects (176 girls, 125 boys) aged 5.2 -18.9 years, with body mass index 490th percentile. Oral glucose tolerance test was performed in all subjects. Previously undiagnosed T2DM was discovered in 0.3% (n ¼ 1) and impaired glucose regulation in 15.9% (n ¼ 48) of the subjects. Isolated IFG was detected in 4.3% (n ¼ 13), isolated IGT in 8.3% (n ¼ 25) and combined IFG and IGT in 3.3% (n ¼ 10) of the subjects. Disturbances of glucose metabolism were present in a substantial number of the subjects, which emphasizes the need for prevention and treatment of childhood obesity.

Prevalence of Type 2 diabetes and pre‐diabetes among overweight or obese children in Tianjin, China

“…Our survey of a representative sample of the children in Tianjin, China, showed the prevalences of Type 2 diabetes and pre‐diabetes among overweight or obese children were 0.28 and 3.30%, similar to those reported from population‐based studies in overweight or obese children in other countries, such as in Iran (0.14% for Type 2 diabetes and 4.61% for impaired fasting glucose) and in Germany (2.5% for the prevalence of the combined impaired fasting glucose, impaired glucose tolerance and Type 2 diabetes) . In contrast, the prevalence of Type 2 diabetes and pre‐diabetes in our population of children was markedly lower than those derived from clinical settings, such as studies in the USA , Germany , Serbia and in China (diabetes2.2%, pre‐diabetes19.6%) . This marked difference highlights the importance of population‐based studies of paediatric diabetes in estimating the burden of diabetes in youth and possible overestimates of prevalence of diabetes and pre‐diabetes in clinic settings.…”

Metabolic syndrome in obese children and adolescents in Serbia: prevalence and risk factors

“…Three subjects (1.2%) in our study group were diagnosed with type 2 diabetes, which correlates with findings from other studies in the region, and the fact that all of these subjects also had MS emphasizes the association between pediatric MS and early complications of childhood obesity (4,17). Higher levels of insulin and insulin resistance were also observed in subjects with MS.…”

“…As in most of European countries, the prevalence of childhood obesity in Serbia is rapidly increasing, which has raised concerns regarding the increase in the prevalence of type 2 diabetes and MS in children and adolescents (30). Although the prevalence of pediatric type 2 diabetes in overweight youth in Serbia has been investigated and is lower compared to the prevalence in the USA, so far there have been no available data on MS prevalence in obese children and adolescents in Serbia using the IDF definition (17).…”

“…The methodology used was the same as in our previous research on metabolic disturbances in obese children (17,18). BMI and height percentiles and standard deviation scores (SDS) were calculated in accordance with the WHO growth reference charts using the WHO Anthro and AnthroPlus software (19,20), and waist circumference percentiles (WC) were calculated according to the reference values of Fernandez et al (21).…”

Insulin resistance in type 2 diabetic youth

“…The pediatric T2DM incidence is currently 8.5 of 100 000, reflecting increased rates of pediatric obesity [3,48]. Similar rates are reported in other countries, with a 0.3% prevalence in Serbia [49 ▪ ], and incidence rates of eight of 100 000 in Japan [50]. In 2010, approximately 17% of US children were obese, up to 50% of obese children in the recent National Health and Nutrition Examination Study had insulin resistance and 10–25% of obese children reportedly have glucose abnormalities [3,26,51].…”