Belay Brook, Kraus Emily M, Porter Renee, Pierce Samantha Lange, Kompaniyets Lyudmyla, Lundeen Elizabeth A, Imperatore Giuseppina, Blanck Heidi M, Goodman Alyson B
Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Public Health Informatics Institute, Atlanta, GA, USA.
Child Obes. 2024 Mar;20(2):96-106. doi: 10.1089/chi.2022.0209. Epub 2023 Mar 17.
Youth with excess weight are at risk of developing type 2 diabetes (T2DM). Guidelines recommend screening for prediabetes and/or T2DM after 10 years of age or after puberty in youth with excess weight who have ≥1 risk factor(s) for T2DM. Electronic health records (EHRs) offer an opportunity to study the use of tests to detect diabetes in youth. We examined the frequency of (1) diabetes testing and (2) elevated test results among youth aged 10-19 years with at least one BMI measurement in an EHR from 2019 to 2021. We examined the presence of hemoglobin A1C (A1C), fasting plasma glucose (FPG), or oral glucose tolerance test (2-hour plasma glucose [2-hrPG]) results and, among those tested, the frequency of elevated values (A1C ≥6.5%, FPG ≥126 mg/dL, or 2-hrPG ≥200 mg/dL). Patients with pre-existing diabetes ( = 6793) were excluded. Among 1,024,743 patients, 17% had overweight, 21% had obesity, including 8% with severe obesity. Among patients with excess weight, 10% had ≥1 glucose test result. Among those tested, elevated values were more common in patients with severe obesity (27%) and obesity (22%) than in those with healthy weight (8%), and among Black youth (30%) than White youth (13%). Among patients with excess weight, >80% of elevated values fell in the prediabetes range. In youth with excess weight, the use of laboratory tests for prediabetes and T2DM was infrequent. Among youth with test results, elevated FPG, 2hrPG, or A1C levels were most common in those with severe obesity and Black youth.
超重青少年有患2型糖尿病（T2DM）的风险。指南建议，对于有≥1个T2DM风险因素的超重青少年，在其10岁后或青春期后进行糖尿病前期和/或T2DM筛查。电子健康记录（EHRs）为研究检测青少年糖尿病的检测方法的使用提供了机会。我们在一份2019年至2021年的EHR中，检查了10至19岁且至少有一次体重指数（BMI）测量值的青少年中（1）糖尿病检测的频率以及（2）检测结果升高的频率。我们检查了糖化血红蛋白（A1C）、空腹血糖（FPG）或口服葡萄糖耐量试验（2小时血浆葡萄糖[2-hrPG]）结果的存在情况，以及在接受检测的人群中，值升高（A1C≥6.5%、FPG≥126mg/dL或2-hrPG≥200mg/dL）的频率。已患有糖尿病的患者（n = 6793）被排除在外。在1,024,743名患者中，17%超重，21%肥胖，其中8%为重度肥胖。在超重患者中，10%有≥1次血糖检测结果。在接受检测的人群中，重度肥胖患者（27%）和肥胖患者（22%）的值升高情况比体重正常者（8%）更常见，在黑人青少年中（30%）比白人青少年中（13%）更常见。在超重患者中，超过80%的值升高处于糖尿病前期范围。在超重青少年中，用于糖尿病前期和T2DM的实验室检测使用频率较低。在有检测结果的青少年中，FPG、2hrPG或A1C水平升高在重度肥胖青少年和黑人青少年中最为常见。
