The incidence of Type 2 diabetes mellitus (T2DM) and Impaired Glucose
Tolerance (IGT) is increasing among children all over the world. In India,
T2DM develops at a younger age, at least a decade earlier, than in Western
population(1). There is paucity of data on prevalence of IGT and T2DM
amongst children suffering from obesity in NCT of Delhi. This data is a
part of larger study data set of study conducted on prevalence of
overweight and obesity amongst school children in Delhi, which has
been published earlier(2). A total of 451 obese children in the age of
6-<18 were identified in this study by IOTF classification(3), of which
154 children, were included in the present study, to assess the prevalence
of T2DM and IGT.
The study was approved by ethics committee of All India
Institute of Medical Sciences, New Delhi. A informed written consent was
taken from parents of each child. Each child was instructed to report
after fasting of 10 hours, on the day of blood collection. On each child,
Oral Glucose Tolerance Test was (OGTT) was conducted as per the
standardized procedure(3). Fasting blood sample was collected from each
child and subsequently child was orally administered with standard glucose
at 1.75g/kg bodyweight but not exceeding a total of 75 g. The glucose was
dissolved in water and child was requested to drink it within 5 minutes.
The time of drinking of glucose solution was noted and after 2-hours the
blood samples were collected.
Obese children with fasting blood glucose levels less
than 126 mg/dL or 2-hour glucose load levels between 140-200 mg/dL were
considered as suffering from IGT. Similarly, children with fasting blood
glucose more than 126 mg/dL or 2-hour glucose level of more than 200 mg/dL
were considered as suffering from T2DM(4). It was found that amongst obese
children, the prevalence of T2DM and IGT was 1.3 and 18.2 percent,
respectively. In an earlier study from Delhi, abnormal glucose tolerance
of 24.8% has been reported amongst overweight and obese children in 5-18
years of age(5). The difference in the results was because these authors
included both overweight and obese children, while in the present study
only obese children were considered. Another study from Italy has
documented the prevalence of IGT and T2DM as 9 and 0.6%, respectively,
amongst obese children in the age group of 6-14 years(6). The variation in
the results observed from present study could be due to difference in the
age group included in the study.
The findings of the present study suggest conducting a
larger study in this field.
References
1. Morre PA, Zgibor JC, Dasanayke AP. Diabetes: a
growing epidemic of all ages. J Am Dent Assoc 2003: 134: 11S-15S.
2. Kaur S, Sachdev HPS, Dwivedi SN, Lakshmy R, Kapil U.
Prevalence of overweight and obesity amongst school children in Delhi,
India. Asia Pacific J Clin Nut 2008; 40: 1112-1115.
3. Cole JC, Mary CB, Katherine MF, William HD.
Establishing a standard definition for child overweight and obesity
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4. American Diabetic Association. Diagnosis and
classification of diabetes mellitus. Diabetes Care 2008; 31: S55-S60.
5. Chathurvedi D, Khagawat R, Kulshrestha B, Gupta N,
Joseph AA, Dwivedi S, et al. Type 2 diabetes increases risk for
obesity among subsequent generations. Diabetes Technol Ther 2009; 11:
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6. Doro Altan AM, Manaca Bitti ML, Buonomo E, Scarcella
P, Mancineilli S, Arcano S, et al. Ecaluation and prevention of
type II diabetes mellitus and cardiovascular diseases in obeswe children
and adolecsnts: a public health intervention in a local helath
organization in Rome (Italy). Ig Sanita Pubbl 2008; 64: 345-360.