Home | About us | Editorial board | Search | Ahead of print | Current issue | Archives | Submit article | Instructions | Subscribe | Contacts | Advertise | Login 
 
Search Article 
  
Advanced search 
  Users Online: 503 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  

 
Table of Contents
BRIEF COMMUNICATION
Year : 2012  |  Volume : 16  |  Issue : 8  |  Page : 483-485

Prevalence of pre-diabetes, diabetes, pre-hypertension, and hypertension in children weighing more than normal


Department of Endocrinology and Metabolism, Samrat Endocrine Institute of Diabetes, Obesity, and Thyroid, Aurangabad, India

Date of Web Publication4-Jan-2013

Correspondence Address:
Hemant Phatale
Department of Endocrinology and Metabolism, Samrat Endocrine Institute of Diabetes, Obesity, and Thyroid, Aurangabad
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.104139

Rights and Permissions
   Abstract 

Aim: Prevalence of pre-diabetes, diabetes, pre-hypertension (pre-HT), and hypertension (HT) in children weighing more than normal. Materials and Methods: Three- to eighteen-year old children weighing more than normal were included. Pathological short children were excluded. According to Centre for Disease Control (CDC), children are grouped into overweight (OW) and obese (OB). Indian B.P. reference tables are used for defining HT and pre-HT. [2] HbA1c by HPLC (BIO RAD) method was used to define pre-diabetes and diabetes. [3] Children with HbA1c ≥6.5 were subjected for Glucose Tolerance Test (GTT). C-peptide assay was done to rule out (r/o) IDDM. Observations: When we compare this with our earlier presentation at PEDICON 2011, we found that hypertension (HTN) (22.9% vs. 23.07%) is not significantly different but pre-HTN (28.09% vs. 33.9%), pre-diabetes mellitus (pre-DM) (3.7% vs. 64.3%), and diabetes mellitus (DM) (0.35% vs. 3.8%) are significantly high in this study. Conclusion: (1) Prevalence of HT (22.90% vs. 23.07%) is similar in both groups but pre-HT (33.9% vs. 28.09%) is high in this study. (2) Significant rise in prevalence of diabetes (3.84% vs. 0.35%) and pre-diabetes (64.33% vs. 3.7%) is seen in this study. (3) This change is because of using HbA1c as screening tool in children weighing more than normal.

Keywords: Blood pressure, Centre for disease control, diabetes mellitus T2, glucose tolerance test, rule out, hypertension, overweight, obese, pre-diabetes mellitus, pre-hypertension


How to cite this article:
Phatale P, Phatale H. Prevalence of pre-diabetes, diabetes, pre-hypertension, and hypertension in children weighing more than normal. Indian J Endocr Metab 2012;16, Suppl S2:483-5

How to cite this URL:
Phatale P, Phatale H. Prevalence of pre-diabetes, diabetes, pre-hypertension, and hypertension in children weighing more than normal. Indian J Endocr Metab [serial online] 2012 [cited 2020 Nov 25];16, Suppl S2:483-5. Available from: https://www.ijem.in/text.asp?2012/16/8/483/104139


   Introduction Top


Worldwide prevalence of childhood overweight (OW) and obesity increased from 4.2% (1990) to 6.7% (2010) and it will reach 9.1% by 2020. [1] About 18 million children from Asia are OW and obese (OB) in 2010. [1] This rise is double in developing countries than developed countries. [1] Obesity in childhood is associated with a wide range of serious health complications and an increased risk of premature illness and death later in life. [2],[3]

In clinical practice, we realized that HbA1c as a screening tool is very important in diagnosing pre-diabetes and diabetes. Hence, we decided to analyze our institutional data.


   Aim Top


Prevalence of pre-diabetes, diabetes, pre-hypertension (pre-HT), and hypertension (HT) in children weighing more than normal.


   Materials and Methods Top


Inclusion criteria:

  1. Children between 3 and 18 years weighing more than normal who attended Samrat Endocrine Institute.
Exclusion criteria:

  1. Pathological short children were excluded
  2. Children with hemoglobinopathies
  3. Anemic children with hemoglobin <9 g%.


Totally, 286 children were qualified for analysis.

According to Centre for Disease Control (CDC), children are grouped into OW (BMI Centile from 85 th to 95 th centile) and OB (95 th and above). [4] Indian B.P. reference tables are used for defining HT (≥95 th centile for age and height ) and pre-HT (90-95centile for age and height). [5] The blood pressure (BP) of 120/80 mm Hg is considered pre-HT even if B.P. centile normal for age and height. HbA1c by HPLC (BIO RAD) method was used to define pre-diabetes and diabetes. [6],[7] Pre-diabetes is defined as whose HbA1c is equal to or greater than 5.7 and less than 6.5. Diabetes is suspected when HbA1c equal to or greater than 6.5. Children with HbA1c ≥ 6.5 were subjected for Glucose Tolerance Test (GTT). Diabetes is defined as HbA1c ≥6.5 and positive OGTT. [6],[7] C-peptide assay was done to rule out (r/o) IDDM. [8]


   Observations Top
[Table 1]

Out of 286 children, 43% (123) were normotensive, 33.9% (97) were pre-hypertensive, 23% (66) were hypertensive [Figure 1].
Figure 1: Prevalence of normotension, prehypertension and hypertension

Click here to view
Table 1: Study observations

Click here to view


Out of 286 children 31.8% (91) were found to have normal HbA1c, 64.3% (184) were found to have pre-diabetes, 3.8% (11) were found to have type 2 diabetes [Figure 2].
Figure 2: Prevalence of normoglycemia, prediabetes and diabetes

Click here to view



   Discussion Top


When we compare this with our earlier presentation at PEDICON 2011, we found that HTN (22.9% vs. 23.07%) is not significantly different but pre-HTN (28.09% vs. 33.9%), Pre-diabetes mellitus (pre-DM) (3.7% vs. 64.3%), and diabetes mellitus (DM) (0.35% vs. 3.8%) are significantly high in this study. It is possible that we might have missed many early diabetics in our earlier presentation at pedicon 2011 as we have not used HbA1c as a screening tool.

Advantages of HbA1c as a screening tool are as follows:

  1. Will help in detecting more numbers of early diabetics.
  2. Can be done at any time of the day irrespective of meal status.
  3. HbA1c assay done by HPLC (BIO RAD) is stable and reproducible.
  4. It is an important tool for counseling of parents and patients especially adolescents in our day-to-day practice.
  5. We also realized that once we diagnose OW and OB kids with type 2 DM and screen their parents, some of them accidently found to have type 2 DM.
  6. HbA1c is cost-effective and better than HOMA-IR index.


 
   References Top

1.de Onis M, Blössner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010;92:1257-64.  Back to cited text no. 1
    
2.Dietz WH. Health consequences of obesity in youth: Childhood predictors of adult disease. Pediatrics 1998;101:518-25.  Back to cited text no. 2
[PUBMED]    
3.Franks PW, Hanson RL, Knowler WC, Sievers ML, Bennett PH, Looker HC. Childhood obesity, other cardiovascular risk factors, and premature death. N Engl J Med 2010;362:485-93.  Back to cited text no. 3
[PUBMED]    
4.Growth Charts - 2000 CDC Growth Charts - United States www.cdc.gov/growthcharts/cdc_charts.htm.  Back to cited text no. 4
    
5.Krishna P, Prasanna Kumar KM, Desai N, Thennarasu K. Blood pressure reference tables for children and adolescents of Karnataka. Indian Pediatr 2006;43:491-501.  Back to cited text no. 5
    
6.International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care 2009;32:1327-34.  Back to cited text no. 6
[PUBMED]    
7.Algorithm for prediabetes and Type 2 diabetes mellitus; identification and intervention for youth. Pprepared by MN Dept of health, MN diabetes screening committee (MDSC) work group and University of Minnesota Pediatric Endocrinology. Available from: http://www.icanpreventdiabetes.org. [Last accessed on Oct 15, 2012].  Back to cited text no. 7
    
8.Ludvigsson J, Afoke AO. Seasonality of type 1 (insulin-dependent) diabetes mellitus: Values of C-peptide, insulin antibodies and haemoglobin A1c show evidence of a more rapid loss of insulin secretion in epidemic patients. Diabetologia 1989;32:84-91.  Back to cited text no. 8
[PUBMED]    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
   Introduction
   Aim
    Materials and Me...
   Observations
   Discussion
    References
    Article Figures
    Article Tables

 Article Access Statistics
    Viewed2069    
    Printed24    
    Emailed4    
    PDF Downloaded302    
    Comments [Add]    

Recommend this journal