Obese Teens and Diabetes

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Obese Teens and Diabetes
Many Obese Teens Have Condition That Precedes Type 2 Diabetes

From NIH, for About.com

Many obese children and adolescents have impaired glucose tolerance, a condition that often appears before the development of type 2 diabetes, according to researchers funded by the National Institutes of Health (NIH). The study findings appear in the March 14 issue of The New England Journal of Medicine.

"This study suggests that many obese children have a high risk for developing type 2 diabetes," said HHS Secretary Tommy G. Thompson. "Researchers have a lot of information on how to prevent and treat type 2 diabetes in adults, but we need to find better ways to prevent and treat the disease in children."

Once seen only in adults, type 2 diabetes has been rising steadily in children, especially minority adolescents Û African Americans, Hispanic Americans, and Native Americans, according to reports from clinics around the country. Although there are no national, population-based data, studies in Cincinnati, Charleston, Los Angeles, San Antonio, and other cities indicate that the percentage of children with newly diagnosed diabetes who are classified as having type 2 diabetes has risen from less than 5 percent before 1994 to 30-50 percent in subsequent years.

"These results strongly imply that intensive efforts to reduce obesity in children and youth who have impaired glucose tolerance will help to prevent their developing type 2 diabetes," said Duane Alexander, M.D., Director of the National Institute of Child Health and Human Development (NICHD). Both NICHD and the National Center for Research Resources (NCRR), another NIH component, funded the study. Both agencies are part of the National Institutes of Health, the HHS agency that sponsors research to uncover knowledge that will lead to better health for everyone.

The scientists from Yale University School of Medicine conducted their study to determine if obese children and teens have impaired glucose tolerance, which, in adults is a known risk factor for type 2 diabetes. The researchers found that the children with impaired glucose tolerance frequently had insulin resistance, a condition that usually precedes type 2 diabetes in adults and is characterized by the inability of fat, muscle, and liver cells to use insulin properly. Eventually, the insulin-producing cells of the pancreas cannot keep up with the body's increasing demand for insulin, glucose builds up in the blood, and type 2 diabetes begins.

"The epidemic of childhood obesity in the United States has been accompanied by a marked increase in the frequency of type 2 diabetes," the study authors wrote.

The researchers tested for impaired glucose tolerance in 55 obese children from 4 to 10 years of age, and 112 obese adolescents from 11 to 18 years of age. In all, 25 percent of the children and 21 percent of the adolescents had impaired glucose tolerance. The researchers also found that four of the adolescents in the study had silent type 2 diabetes, a form of diabetes that doesn't cause any symptoms.

"Impaired glucose tolerance is highly prevalent among children and adolescents with severe obesity, irrespective of ethnic group," the researchers wrote.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the part of the NIH with lead responsibility for diabetes research, is funding clinical trials to prevent and treat type 2 diabetes in children. These studies, currently being planned for recruitment next year, will try to develop ways to stem the rising rate of type 2 diabetes in children and to treat the disease safely and effectively in those who do develop it.

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