Impaired glucose tolerance in obese white children and adolescents: three to five year follow-up in untreated patients

Abstract

Objective: Impaired glucose tolerance (IGT) is a predictor of type 2 diabetes in adults. However, the converting rate from IGT to diabetes is largely unknown in obese children.

Methods: We analyzed all 128 obese white European children diagnosed with IGT at our institution in the years 2003-2006 (mean age 13.5 ± 2.1 years, 53% female, mean BMI 31.7 ± 6.1 kg/m²) 3.0-5.6 years (mean 3.9 ± 0.6 years) later with an oral glucose tolerance test (oGTT).

Results: At follow-up, 20 (16%) children remained in the IGT status, 96 (75%) children converted to normal glucose metabolism, 3 (2%) children developed type 2 diabetes, and 9 (7%) children were lost to follow-up. Comparing the children according to their outcome concerning glucose metabolism at follow-up demonstrated that 2 h glucose levels in oGTT at baseline were significantly (p<0.001) higher in the children remaining IGT and highest in children developing diabetes, while the children did not differ in respect of age, gender, BMI, blood pressure, fasting glucose levels at baseline, or length of follow-up period. Apart from children developing diabetes, who increased their body weight, all the other children did not change their BMI, blood pressure, or fasting glucose levels significantly at follow-up.

Conclusions: Obese white children with IGT will likely convert to normal glucose metabolism in the next 3-5 years. Risk factors for developing type 2 diabetes in follow-up were higher 2 h glucose levels in oGTT at baseline and weight gain.

Trial registration: ClinicalTrials.gov NCT00435734.