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Pediatric obesity increases type 2 diabetes risk in young adulthood
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Swedish normoglycemic children receiving treatment for obesity were nearly 19 times more likely to be prescribed diabetes medication as young adults vs. children without obesity, according to recent findings.
“This study confirms that the pediatric obese population has a markedly higher prevalence of [type 2 diabetes] in early adulthood in relation to a population-based comparison group, regardless of gender and ethnicity,” Emilia Hagman, a PhD student in the department of clinical science, intervention and technology at the Karolinska Institute in Stockholm, and colleagues wrote. “We have used [type 2 diabetes] medication collection as a proxy for [type 2 diabetes], as the majority of young adults in Sweden with [type 2 diabetes] have been prescribed such medication.”
In a prospective cohort study, Hagman and colleagues analyzed data from 1,620 children and adolescents included in the national registry for treatment of childhood obesity between March 1995 and April 2013, as well as 8,046 children from the Swedish Total Population Register matched by sex, age and living area as a comparison group. Children included in the obesity cohort underwent a fasting glucose measurement. Impaired fasting glucose was stratified by both WHO (6.1 mmol/L) and American Diabetes Association standards (5.6 mmol/L). Primary outcome was diabetes medications prescribed in young adulthood as a proxy for type 2 diabetes, using data from a national registry.
Within the cohort, 0.1% of children in the control group went on to collect type 2 diabetes medications vs. 2.4% of normoglycemic children with obesity, 4.6% of children with ADA-defined IFG and obesity and 10.5% of children with WHO-defined IFG and obesity.
Researchers found that, overall, children in the obesity group were 24 times more likely to receive type 2 diabetes medications in early adulthood vs. controls (95% CI, 12.52-46), with an adjusted HR of 18.49 (95% CI, 9.29-36.8).
WHO-defined IFG predicted the future use of type 2 diabetes medications vs. those with ADA-defined IFG (adjusted HR = 3.73; 95% CI, 1.87–7.45). In addition, ADA-defined IFG did not increase the use of type 2 diabetes medication more than pediatric obesity itself (adjusted HR = 1.72; 95% CI, 0.84–3.52).
Elevated HbA1c levels in childhood also predicted future type 2 diabetes (adjusted HR = 3.12; 95% CI, 1.50–6.52). More severe degree of obesity also increased the future diabetes risk. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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