Insulin Resistance, Impaired fasting, Glucose Intolerance and Type II Diabetes Mellitus in Overweight and Obese Children in Abu Dhabi

Abstract

Background: Obesity is increasingly seen in children and youth. It is linked to major health concerns including glucose intolerance and type II diabetes. Childhood obesity in the Gulf and some other regions around the world has dramatically increased to reach an epidemic proportion. We aim to study the prevalence of obesity comorbidities in terms of glucose metabolism in overweight and obese children and adolescents in Abu Dhabi, UAE. Method(s): Overweight and obese children and adolescents are enrolled in an observational, cross-sectional study. Patients had detailed demographic and family history taken. Standardized weight, height, BMI and waist circumference were recorded. Laboratory tests included fasting glucose, insulin and HbA1c were done. Patients who had high fasting glucose or HbA1c had standard oral glucose tolerance test. Insulin sensitivity was assessed by applying HOMA-index. Result(s): 216 patients (121 males) were enrolled. Mean age was 10.58 +/- 2.9 years. 93% were obese and 7% overweight. 173 patients had a waist circumference >= 90th centile. 147 patients (74.2%) were insulin resistant. 7 patients were diagnosed with diabetes (6 had HbA1c above 6.5, 1 had 2 fasting glucose measurements above 7 mmol/L). 87 (43.5%) had an indication for OGTT; 26 elevated fasting, 50 elevated HbA1c, 11 had both. 15 patients (8.2%) had impaired glucose tolerance and 37 (18.1) had impaired fasting. 5 patients of 11 with impaired fasting (45.5%) and 8 patients of 50 elevated HbA1c (17.4%) had glucose intolerance. Conclusion(s): Insulin resistance is common in overweight and obese children and is more commonly seen in older children with high weight, height and waist circumference. Higher yield of glucose intolerance is obtained when screening utilized combination of high fasting glucose and HbA1c.