Assessment of prediabetes and medical interventions in a sample of overweight Michigan youth.

摘要

Study objectives. The objectives of this study were to (1) assess current screening practices for prediabetes in youth, (2) determine the existence of prediabetes in a sample of overweight youth, (3) describe associative factors related to prediabetes in youth, and (4) assess current clinical recommendations provided, including medical nutrition therapy, physical activity, and the prescription of metformin.; Study design. A cross-sectional, retrospective medical record review of subjects aged 6 to 18 years with a body mass index percentile 85th percentile seeking care for their overweight condition with pediatric endocrinologist.; Results. 53% of the sample received screening for prediabetes. Greater than 60% of the sample met the criteria for metablolic syndrome. Prediabetes was detected in 13.5% of those screened. Youth with prediabetes had significantly higher levels of fasting blood glucose (p>0.001), serum insulin (p0.001), insulin-to-glucose ratio (p0.01), and systolic blood pressure (p0.001). The majority of youth seen for prediabetes received nutrition education similar to that prescribed to adults.; Conclusion. Overweight youth under the care of endocrinologists are not being adequately screened for prediabetes. The majority of youth presenting for care have documented metabolic disturbances. Those with prediabetes have significantly higher levels of biomarkers indicative of insulin resistance and abnormal glucose tolerance.