Absence of diabetes mellitus type 2 in obese children and adolescents in the north of Spain.

BACKGROUND

The worldwide epidemic of childhood obesity has been accompanied by an increase in the incidence of carbohydrate metabolism disorders.

OBJECTIVE

To determine the prevalence of type 2 diabetes mellitus (T2DM) and other carbohydrate metabolism disorders in obese young people in the Basque Country (Spain).

DESIGN

Prospective observational study.

PATIENTS

We studied 136 obese Caucasian children and adolescents (body mass index ≥2 SDS above the mean).

MEASUREMENTS

Their severity of obesity was classified as mild <3 SDS or moderate-to-severe ≥3 SDS. Data were collected on clinical and metabolic parameters; insulin resistance (IR) was calculated using the homeostasis model assessment, and an oral glucose tolerance test (OGTT) was carried out.

RESULTS

T2DM was not found. Impaired glucose tolerance (IGT) was found in 9.6% of patients being higher in moderate-to-severe obesity (12.8% vs. 2.4%; p=0.048) and in patients with acanthosis nigricans (27.8% vs. 6.8%; p=0.016). No differences were detected by sex or pubertal development in metabolic results as a function of OGTT's response. IR (13.5%) was higher among those with moderate-to-severe obesity, in patients with acanthosis nigricans and was associated with other cardiovascular disease risk factors.

CONCLUSIONS

We found no children with T2DM. The prevalence of IGT and IR was related to severity of obesity, to the association of acanthosis nigricans and was associated with cardiovascular risk.