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Risk Factors for Progression to Type 2 Diabetes in a Pediatric Prediabetes Clinic Population

BACKGROUND: Pediatric type 2 diabetes (T2D) is increasing in prevalence, yet it is unclear what definition of pediatric prediabetes predicts progression to T2D. Strategies are needed to better identify at risk individuals who could benefit from early intervention. METHODS: Retrospective chart review...

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Autores principales: Belsky, Natasha, Tamaroff, Jaclyn, Shoemaker, Ashley H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569239/
https://www.ncbi.nlm.nih.gov/pubmed/37841954
http://dx.doi.org/10.1210/jendso/bvad118
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author Belsky, Natasha
Tamaroff, Jaclyn
Shoemaker, Ashley H
author_facet Belsky, Natasha
Tamaroff, Jaclyn
Shoemaker, Ashley H
author_sort Belsky, Natasha
collection PubMed
description BACKGROUND: Pediatric type 2 diabetes (T2D) is increasing in prevalence, yet it is unclear what definition of pediatric prediabetes predicts progression to T2D. Strategies are needed to better identify at risk individuals who could benefit from early intervention. METHODS: Retrospective chart review of a pediatric prediabetes clinic over 7 years. Inclusion criteria include hemoglobin A1c (HbA1C) and ≥1 glucose from oral glucose tolerance test. Exclusion criteria include type 1 diabetes, maturity onset diabetes of the young, or T2D on initial visit. RESULTS: A total of 552 patients were included, 6.5% (n = 36) progressed to T2D over 2.4 ± 1.5 years. At initial visit, T2D progressors had a higher body mass index (38.6 ± 6.5 vs 34.2 ± 8.4 kg/m(2), P = .002), HbA1C (6.0 ± 0.3%, vs 5.7± 0.3, P < .001), 2-hour glucose (141 ± 28 vs 114 ± 29 mg/dL, P < .001), and C-peptide (4.8 vs 3.6 ng/mL, P = .001). Fasting glucose was not significantly different. In a multivariable model, male sex (hazard ratio [HR], 2.4; P = .012), initial visit HbA1C (HR, 1.3 per 0.1% increase; P < .001), and 2-hour glucose level (HR, 1.2 per 10 mg/dL increase; P = .014) were all predictive of T2D progression. Patients who progressed to T2D had an increase in body mass index of 4.2 kg/m(2) and children consistently taking metformin took longer to progress (43 ± 21 vs 26 ± 16 months; P = .016). DISCUSSION: A total of 6.5% of patients with prediabetes developed T2D over a 7-year period. Initial visit laboratory values and weight trajectory may allow for risk stratification, whereas fasting plasma glucose is less helpful. Weight stabilization and metformin therapy could be important interventions for diabetes prevention in children.
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spelling pubmed-105692392023-10-13 Risk Factors for Progression to Type 2 Diabetes in a Pediatric Prediabetes Clinic Population Belsky, Natasha Tamaroff, Jaclyn Shoemaker, Ashley H J Endocr Soc Clinical Research Article BACKGROUND: Pediatric type 2 diabetes (T2D) is increasing in prevalence, yet it is unclear what definition of pediatric prediabetes predicts progression to T2D. Strategies are needed to better identify at risk individuals who could benefit from early intervention. METHODS: Retrospective chart review of a pediatric prediabetes clinic over 7 years. Inclusion criteria include hemoglobin A1c (HbA1C) and ≥1 glucose from oral glucose tolerance test. Exclusion criteria include type 1 diabetes, maturity onset diabetes of the young, or T2D on initial visit. RESULTS: A total of 552 patients were included, 6.5% (n = 36) progressed to T2D over 2.4 ± 1.5 years. At initial visit, T2D progressors had a higher body mass index (38.6 ± 6.5 vs 34.2 ± 8.4 kg/m(2), P = .002), HbA1C (6.0 ± 0.3%, vs 5.7± 0.3, P < .001), 2-hour glucose (141 ± 28 vs 114 ± 29 mg/dL, P < .001), and C-peptide (4.8 vs 3.6 ng/mL, P = .001). Fasting glucose was not significantly different. In a multivariable model, male sex (hazard ratio [HR], 2.4; P = .012), initial visit HbA1C (HR, 1.3 per 0.1% increase; P < .001), and 2-hour glucose level (HR, 1.2 per 10 mg/dL increase; P = .014) were all predictive of T2D progression. Patients who progressed to T2D had an increase in body mass index of 4.2 kg/m(2) and children consistently taking metformin took longer to progress (43 ± 21 vs 26 ± 16 months; P = .016). DISCUSSION: A total of 6.5% of patients with prediabetes developed T2D over a 7-year period. Initial visit laboratory values and weight trajectory may allow for risk stratification, whereas fasting plasma glucose is less helpful. Weight stabilization and metformin therapy could be important interventions for diabetes prevention in children. Oxford University Press 2023-10-12 /pmc/articles/PMC10569239/ /pubmed/37841954 http://dx.doi.org/10.1210/jendso/bvad118 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Article
Belsky, Natasha
Tamaroff, Jaclyn
Shoemaker, Ashley H
Risk Factors for Progression to Type 2 Diabetes in a Pediatric Prediabetes Clinic Population
title Risk Factors for Progression to Type 2 Diabetes in a Pediatric Prediabetes Clinic Population
title_full Risk Factors for Progression to Type 2 Diabetes in a Pediatric Prediabetes Clinic Population
title_fullStr Risk Factors for Progression to Type 2 Diabetes in a Pediatric Prediabetes Clinic Population
title_full_unstemmed Risk Factors for Progression to Type 2 Diabetes in a Pediatric Prediabetes Clinic Population
title_short Risk Factors for Progression to Type 2 Diabetes in a Pediatric Prediabetes Clinic Population
title_sort risk factors for progression to type 2 diabetes in a pediatric prediabetes clinic population
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569239/
https://www.ncbi.nlm.nih.gov/pubmed/37841954
http://dx.doi.org/10.1210/jendso/bvad118
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