Objective: To examine factors related to progression of dysglycemia in overweight and obese youth in a large primary care setting.
Research Design And Methods: 10- to 18-year-old youth with body mass index (BMI) > 85 percentile and first-time A1c 5.7%-7.9% (39-63 mmol/mol) were identified retrospectively through electronic medical records (EMR). Levels of dysglycemia were defined as low-range prediabetes (LRPD; A1c 5.7%-5.9% [39-41 mmol/mol]), high-range prediabetes (HRPD; A1c 6.0%-6.4% [42-46 mmol/mol]), or diabetes-range (A1c 6.5%-7.9% [48 mmol/mol]). Follow-up A1c and BMI were extracted from the EMR. Follow up was truncated at the time of initiation of diabetes medication.
Results: Of 11 000 youth, 547 were identified with baseline dysglycemia (mean age 14.5 ± 2.2 years, 70% Hispanic, 23% non-Hispanic Black, 7% other). Of these, 206 had LRPD, 282 HRPD, and 59 diabetes. Follow-up A1c was available in 420 (77%), with median follow up of 12-22 months depending on A1c category. At follow-up testing, the percent with diabetes-range A1c was 4% in youth with baseline LRPD, 8% in youth with baseline HRPD, and 33% in youth with baseline diabetes-range A1c. There was a linear association between BMI increase and worsening A1c for LRPD (P < .001) and HRPD (P = .003).
Conclusions: Most adolescents with an initial prediabetes or diabetes-range A1c did not have a diabetes-range A1c on follow up. Moreover, prediabetes-range A1c values do not all convey equal risk for the development of diabetes, with lower rates of progression for youth with initial A1c <6%. In youth with prediabetes-range A1c, BMI stabilization was associated with improvement of glycemia.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/pedi.12570 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Estimating the Rates of Undiagnosed Prediabetes and Diabetes Among People Experiencing Homelessness.
Can J Diabetes
August 2024
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address:
Article Synopsis
- The study investigates the prevalence of undiagnosed type 2 diabetes among people experiencing homelessness in Calgary, highlighting significant barriers they face in accessing diabetes screening.
- Four screening clinics utilized point-of-care A1C testing to evaluate participants, revealing that 17 individuals had previously undiagnosed dysglycemia, including cases of prediabetes and diabetes.
- The findings indicate a high rate of undiagnosed diabetes among this vulnerable population, suggesting an urgent need for improved healthcare resources and initiatives to facilitate diabetes screening and support.
Glycemic Markers and Heart Failure Subtypes: The Multi-Ethnic Study of Atherosclerosis (MESA).
J Card Fail
November 2022
Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
Background: Although diabetes increases heart failure (HF) risk, it is unclear how various dysglycemia markers (hemoglobin A [HbA], fasting plasma glucose [FPG], homeostasis model assessment of insulin resistance, and fasting insulin) are associated with HF subtypes (HF with preserved ejection fraction [HFpEF] and HF with reduced ejection fraction [HFrEF]). We assessed the relation of markers of dysglycemia and risks of HFpEF and HFrEF.
Methods And Results: We included 6688 adults without prevalent cardiovascular disease who attended the first MESA visit (2000-2002) and were followed for incident hospitalized HF (HFpEF or HFrEF).
Glycated Hemoglobin A, Lung Function, and Hospitalizations Among Adults with Asthma.
J Allergy Clin Immunol Pract
May 2021
Division of Pediatric Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa. Electronic address:
Background: Insulin resistance and metabolic dysfunction have been associated with asthma risk and asthma severity.
Objective: To examine the association between glycated hemoglobin A (HbA), asthma-related hospitalizations, and lung function measures among adults in the United Kingdom.
Methods: A cross-sectional study was conducted of 47,606 adults aged 40 to 69 years who participated in the UK Biobank and had asthma but no diagnosis of diabetes mellitus.
Racial/Ethnic Differences in Diabetes Screening and Hyperglycemia Among US Women After Gestational Diabetes.
Prev Chronic Dis
October 2019
Applied Sciences, Premier, Inc, Charlotte, North Carolina.
Introduction: Gestational diabetes mellitus (GDM) is the most common complication of pregnancy and is associated with an increased risk for type 2 diabetes. Racial/ethnic minority populations are at a higher risk than non-Hispanic white populations of developing type 2 diabetes after GDM. The aim of this study was to describe racial/ethnic differences in hyperglycemia and receipt of screening services in a nationally representative sample of women with a history of GDM.
View Article and Find Full Text PDFA Pilot Study of School-Based Comprehensive Cardiovascular Screening in Middle School Children.
J Pediatr
May 2019
Heart Institute, Cincinnati Children's, Cincinnati, OH; University of Cincinnati, College of Medicine, Cincinnati, OH.
Although recommended, most children are not routinely screened for lipid abnormalities and diabetes. We report a pilot of universal screening for diabetes, lipid abnormalities, and hypertension in the middle-school setting. Of 45 children screened, 34.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!