Severely Obese Children Have Dangerously Increased Risk of Type 2 Diabetes

A study presented at the American Diabetes Association (ADA)’s 77th Scientific Session in San Diego, California, revealed that severely obese American Indian children 5 to 9 years of age had a 12-times higher risk of developing type 2 diabetes (T2D) by age 20 as normal-weight youth in the same age range, according to a study titled “Long-term Risk of Type 2 Diabetes in Youth with Increasing Severity of Obesity.”

“We had previously found BMI in youth to be a strong predictor of type 2 diabetes, but we had not examined diabetes incidence rates in those with the severe degree of obesity that is prevalent today,” Madhumita Sinha, MD, MHSM, staff clinician at the Diabetes Epidemiology and Clinical Research Section of the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health, Phoenix, Arizona, said. “We did not know if diabetes incidence rates among the obese plateaued among those with extremely high BMI. This study clearly shows that the risk of developing type 2 diabetes is associated with BMI, especially at very high extremes.”

The Centers for Disease Control and Prevention defines obesity as being at or above a cut point which is specified as the 95th percentile. It is a serious health problem in youth, and especially in populations already at high risk of developing T2D.

The longitudinal study examined the risk of developing diabetes and other metabolic abnormalities in obese and severely obese American Indian youths from the southwestern United States, which is a population at high risk of developing T2D. Incidence was studied in 2728 children without diabetes, who were aged 5 to 9 years, and a partially overlapping group of 4317 youths, who were aged 10 to 17 years. They were followed up to age 45 or until the onset of T2D. Age- and sex-specific body mass index (BMI) percentiles were defined by the CDC’s 2000 growth charts.

Previous studies have found a strong relationship between high body mass index (BMI) in childhood and subsequent development of T2D in adults and adolescents. However, studies have not assessed the long-term risk in youths with extremely high BMIs.

Compared with non-obese children aged 5 to 9 years who had BMIs in the middle of the distribution, children of the same age with BMIs at least 40% above the cut point defining obesity had 12 times the incidence rates of T2D by 20 years of age, and 3 times the incidence by 45 years of age.

“Parents and healthcare providers should be aware of the future diabetes risk associated with obesity in youth, especially as more severe degrees of obesity become more prevalent,” Sinha concluded. “Results of our analysis emphasize the importance of developing effective means of preventing or treating obesity in youth, and additional risk factors for type 2 diabetes in youth should be explored for their interactions with severe obesity.”

The ADA’s 77th Scientific Sessions, covering more than 3,000 original research presentations grouped into 8 interest areas, conclude June 13, 2017.