Frequency of Abnormal Carbohydrate Metabolism and Diabetes in a Population-based Screening of Adolescents

• Published in: The Journal of pediatrics Vol. 146; no. 6; pp. 751 - 758
• Main Authors: Dolan, Lawrence M., Bean, Judy, D'Alessio, David, Cohen, Robert M., Morrison, John A., Goodman, Elizabeth, Daniels, Stephen R.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-06-2005; Elsevier
• Subjects: Adolescent; Biological and medical sciences; Blood Glucose - analysis; Body Mass Index; Continental Population Groups; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; Dietary Carbohydrates - metabolism; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fasting; Female; General aspects; Humans; Logistic Models; Male; Mass Screening; Medical sciences; Ohio - epidemiology; Prospective Studies; Puberty; Regression Analysis; Risk Factors; Suburban Population; Urban Population; Ohio; PSD; AA; ICA 512; CI; IAA; IR; RIA; IFG; GAD; CV; ANOVA; IGT; NHANES; NHW; OGT; BMI; Endocrinopathy; Human; Pediatrics; Diabetes mellitus; Adolescent; Frequency; Carbohydrate; Medical screening; Metabolism; Public health
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2005.01.045

To document the frequency of glucose intolerance in adolescents in a population-based study of primarily African-American/Non-Hispanic whites in an urban-suburban school district.
Measurement of fasting and 2-hour post-glucose load plasma glucose concentrations.
Carbohydrate intolerance (either impaired fasting glucose, impaired glucose tolerance, or both) was identified in 8.0%, near-diabetes (1 fasting glucose ≥126 mg/dL [7.0 mmol/L] and/or 2-hour glucose ≥200 mg/dL [11.1 mmol/L]) in 0.3%, and diabetes in 0.36% (type 1A
=
0.24%; type 2
=
0.08%; undiagnosed type 2
=
0.04%). A model for abnormal carbohydrate metabolism was constructed with regression analysis in the Carbohydrate Intoelrance (CI)/near-diabetes group and with logistic regression in the entire study population. Risk factors for the development of CI/near-diabetes included having a 1 unit increase in body mass index (BMI) z-score and either being non-Hispanic white or in the pubertal group. Increased fasting glucose correlated with having puberty and decreased BMI z-score, whereas 2-hour glucose correlated with increased BMI z-score. By using National Health and Nutrition Survey (NHANES) III (1988-1994) definitions, impaired fasting glucose was present in 2.0% in this study versus 1.7% (NHANES III).
The prevalence of CI/near-diabetes was 8.3%. Undiagnosed diabetes mellitus was rare. One third of adolescents with diabetes mellitus could be classified as having type 2 diabetes mellitus. The adult model of the progression of insulin resistance to type 2 diabetes mellitus in adolescents may be valid. Despite the increase in the overweight population since NHANES III, abnormalities in glucose metabolism have not changed significantly.