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Prevalence of Impaired Glucose Tolerance among Children and Adolescents with Marked Obesity
Open accessAbstract
BACKGROUND: Childhood obesity, epidemic in the United States, has been accompanied by an increase in the prevalence of type 2 diabetes among children and adolescents. We determined the prevalence of impaired glucose tolerance in a multiethnic cohort of 167 obese children and adolescents. METHODS: All subjects underwent a two-hour oral glucose-tolerance test (1.75 g [DOSAGE ERROR CORRECTED] of glucose per kilogram of body weight), and glucose, insulin, and C-peptide levels were measured. Fasting levels of proinsulin were obtained, and the ratio of proinsulin to insulin was calculated. Insulin resistance was estimated by homeostatic model assessment, and beta-cell function was estimated by calculating the ratio between the changes in the insulin level and the glucose level during the first 30 minutes after the ingestion of glucose. RESULTS: Impaired glucose tolerance was detected in 25 percent of the 55 obese children (4 to 10 years of age) and 21 percent of the 112 obese adolescents (11 to 18 years of age); silent type 2 diabetes was identified in 4 percent of the obese adolescents. Insulin and C-peptide levels were markedly elevated after the glucose-tolerance test in subjects with impaired glucose tolerance but not in adolescents with diabetes, who had a reduced ratio of the 30-minute change in the insulin level to the 30-minute change in the glucose level. After the body-mass index had been controlled for, insulin resistance was greater in the affected cohort and was the best predictor of impaired glucose tolerance. CONCLUSIONS: Impaired glucose tolerance is highly prevalent among children and adolescents with severe obesity, irrespective of ethnic group. Impaired oral glucose tolerance was associated with insulin resistance while beta-cell function was still relatively preserved. Overt type 2 diabetes was linked to beta-cell failure.
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“Insulinogenic index (IGI) is a measure of insulin secretion that has been validated in children against the hyperglycemic clamp (16)”
From Sleep architecture and glucose and insulin homeostasis in obese adolescents (2011) · cites this paper as [16]
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Metadata
- Authors
- Sinha, R., Fisch, G., Teague, B., Tamborlane, W. V., Banyas, B., Allen, K., Savoye, M., Rieger, V., Taksali, S., Barbetta, G., Sherwin, R. S., & Caprio, S.
- Affiliations
- Yale University (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2002-03-14
- Volume
- 346
- Issue
- 11
- Pages
- 802-810
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2067262787
- Semantic Scholar
- 0e6b33798ee36c635a2c1e99c405ac1fa5d5233c
- Cited by
- 1,709
- References
- 28
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 27 · 2023: 29 · 2022: 46 · 2021: 35 · 2020: 37 · 2019: 35 · 2018: 49 · 2017: 44 · 2016: 60 · 2015: 65 · 2014: 65 · 2013: 87 · 2012: 90
- FWCI
- 73.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (M01RR000125, M01RR006022, M01 RR-00125, M01 RR-06022)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01-HD- 28016, R01HD028016, R01-HD40787, K24HD001464, R01HD040787, K24-HD01464)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- impaired glucose tolerance, childhood obesity, adolescent obesity, type 2 diabetes, insulin resistance, beta-cell function, proinsulin/insulin ratio, C-peptide, oral glucose tolerance test, prevalence, ethnic differences
- MeSH terms
- Insulin Secretion, Adolescent, Blood Glucose, C-Peptide, Child, Child, Preschool, Cross-Sectional Studies, Diabetes Mellitus, Female, Glucose, Glucose Tolerance Test, Hispanic or Latino, Humans, Insulin, Male, Obesity, Proinsulin, Risk Factors, Prevalence, Black People, White People
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