Evidence for identifying children at risk for being overweight, cardiovascular disease, and type 2 diabetes in primary care

Abstract

Introduction: Practitioners have noted the escalating risk for children being overweight and having cardiovascular disease and type 2 diabetes. The purpose of this study was to apply current recommendations in examining children and to test an expanded model of assessment to predict risk.

Method: A nonexperimental descriptive design was applied at an academic nurse-managed clinic. Children who consented to participate (n = 118) were examined for height/weight (and calculated body mass index), blood pressure, family history, smoking exposure, acanthosis nigricans, and point-of-care nonfasting blood analysis of glucose, hemoglobin A(1C), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. Children with a body mass index greater than the 85th percentile were invited to return for fasting venipuncture, testing glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides (n = 23).

Results: High rates of being overweight and additional risk factors were identified. Point-of-care machines had limited usefulness beyond usual measurements in identifying childhood risk.

Discussion: Recommendations are made for nurses to take careful family histories and complete analysis of physical measurement to identify children needing further intervention to prevent and treat being overweight and disease risks.