American Diabetes Association Release: Severe Obesity In High-Risk Youth Correlates Directly To Increased Incidence Of Type 2 Diabetes

SAN DIEGO, June 9, 2017 /PRNewswire-USNewswire/ -- The risk of developing type 2 diabetes (T2D) by age 20 was 12 times as high in severely obese American Indian children 5 to 9 years of age as in normal-weight youth in that age range, according to a study titled "Long-term Risk of Type 2 Diabetes in Youth with Increasing Severity of Obesity," presented today at the American Diabetes Association's 77th Scientific Sessions® at the San Diego Convention Center.

Obesity is a serious health problem among youth, especially in populations at high risk of developing T2D. Previous studies of obesity in youth have reported a strong relationship between body mass index (BMI) and subsequent incidence of T2D in adults and adolescents. However, prior studies have not assessed the long-term risk in youths with extremely high BMIs, i.e., the severe degrees of obesity often seen today.

This longitudinal study examined the risk of diabetes and other metabolic abnormalities in obese and severely obese American Indian youths from the southwestern U.S., a population with a high risk of developing T2D. The incidence of T2D was computed in 2,728 children without diabetes aged 5-9 years, and a partially overlapping group of 4,317 youths aged 10-17 years. They were followed up to age 45 or until the onset of T2D. Age-sex specific BMI percentiles were defined by the 2000 U.S. Centers for Disease Control and Prevention (CDC) growth charts. The CDC defines obesity as being at or above a cut-point specified as the 95th BMI percentile.

T2D incidence rates increased in direct proportion with severity of obesity. Compared with 5-9-year old nonobese children with BMIs in the middle of the BMI distribution, children of the same age with BMIs at least 40 percent above the cut-point defining obesity had 12 times the incidence rates of T2D by age 20 years and 3 times the incidence rates of T2D by age 45 years. BMI had similar effects on T2D incidence in those 10-17 years old at baseline.

"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. We did not know if diabetes incidence rates among the obese plateaued among those with extremely high BMI," said study author 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 (NIDDK) at the National Institutes of Health (NIH) in Phoenix, Ariz. "This study clearly shows that the risk of developing type 2 diabetes is associated with BMI, especially at very high extremes."

"Parents and health care providers should be aware of the future diabetes risk associated with obesity in youth, especially as more severe degrees of obesity become more prevalent," explained Sinha. "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."

To speak with Dr. Sinha, please contact the Association's media relations team on-site at the San Diego Convention Center on June 9 -13, by phone at 619-525-6250 or by email at press@diabetes.org. Dr. Sinha can also be reached via the NIDDK communications office at NIDDKmedia@niddk.nih.gov or 301-496-3583.

The American Diabetes Association's 77th Scientific Sessions, to be held June 9-13, 2017, at the San Diego Convention Center, is the world's largest scientific meeting focused on diabetes research, prevention and care. During the five-day meeting, health care professionals have exclusive access to more than 2,500 original research presentations, participate in provocative and engaging exchanges with leading diabetes experts, and can earn Continuing Medical Education (CME) or Continuing Education (CE) credits for educational sessions. The program is grouped into eight interest areas: Acute and Chronic Complications; Behavioral Medicine, Clinical Nutrition, Education and Exercise; Clinical Diabetes/Therapeutics; Epidemiology/Genetics; Immunology/Transplantation; Insulin Action/Molecular Metabolism; Integrated Physiology/Obesity; and Islet Biology/Insulin Secretion. Brenda Montgomery, RN, MSHS, CDE, President of Health Care and Education1, will deliver her address on Saturday, June 10, and Alvin C. Powers, MD, President of Medicine and Science, will present his address on Sunday, June 11. Eight abstracts were selected by the Scientific Sessions Meeting Planning Committee to be presented on Tuesday, June 13, in the President's Oral Session. These abstracts represent important research being conducted in the field of diabetes today. In total, the 2017 Scientific Sessions includes 378 abstracts in 49 oral sessions; 2,152 poster presentations including 50 moderated poster discussions; and 360 published-only abstracts.

About the American Diabetes Association
More than 29 million Americans have diabetes, and every 23 seconds another person is diagnosed with diabetes. The American Diabetes Association (Association) is the global authority on diabetes and since 1940 has been committed to its mission to prevent and cure diabetes and to improve the lives of all people affected by diabetes. To tackle this global public health crisis, the Association drives discovery in research to treat, manage and prevent all types of diabetes, as well as to search for cures; raises voice to the urgency of the diabetes epidemic; and provides support and advocacy for people living with diabetes, those at risk of developing diabetes and the health care professionals who serve them. For more information, please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit diabetes.org. Information from both of these sources is available in English and Spanish. Find us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn). 

12-OR  Long-Term Risk of Type 2 Diabetes in Youth with Increasing Severity of Obesity

77th Scientific Sessions
News Briefing: Youth with Diabetes, Saturday, June 10, 4:00 p.m. PT

Oral Presentation: Obesity and Type 2 Diabetes in Children What's New?
Location: 23
Session Time: Friday, June 9, 2017, 4:15 - 6:15 p.m.

Authors: SANIL P. REDDY, STEPHANIE K. TANAMAS, MELISSA CHAMBERS, ELENA CLARK, DIANA DUNNIGAN, ROBERT G. NELSON, ROBERT L. HANSON, WILLIAM C. KNOWLER, MADHUMITA SINHAPhoenixAZ

Background: Few studies assess the long-term risk of developing type 2 diabetes (T2DM) in obese youth. The objective of this study was to determine T2DM risk among obese and severely obese American Indian youth from the southwestern U.S.

Methods: Incidence of T2DM was computed in 4,883 nondiabetic youths ages 10-17 years who were enrolled between 1965 and 2007 and followed for up to 20 years or until the onset of T2DM. Age-sex adjusted BMI %iles were defined using the CDC 2000 growth charts. Obese youth were further classified by % of 95th %ile to demonstrate the effect of severity of obesity on incidence.

Results: Median age of the cohort at baseline was 12.1 years (IQR: 11.7-13.7), 53.4% were female. Over a median follow up of 11.7 years (IQR: 5.3-20.0), 648 youths developed T2DM (11.1 per 1000 person-years). T2DM incidence rates increased with severity of obesity and were generally higher in girls (Figure A). Compared to those with a BMI between the 50th-75th %ile, obese girls had 3 to 7-fold higher and obese boys had 6 to 20-fold higher diabetes incidence rates (Figure B).

Conclusion: This longitudinal study assesses long-term diabetes risk with incremental increase in BMI among obese youth, it shows that risk continues to increase with increasing obesity severity above the 95th %ile; our study adds to the understanding of the metabolic risk gradient in obesity and will help in planning early therapeutic interventions to mitigate this risk.

Author Disclosures: S.P. Reddy: None. S.K. Tanamas: None. M. Chambers: None. E. Clark: None. D. Dunnigan: None. R.G. Nelson: None. R.L. Hanson: None. W.C. Knowler: None. M. Sinha: None.

1 Disclosures for Brenda Montgomery. Employer: AstraZeneca Pharmaceuticals. Montgomery's role as President, Health Care & Education of the American Diabetes Association (Association) is a voluntary position to which she was elected by the members of the Association in 2015. She continues to recuse herself from any and all discussions, decisions or votes that have or could be perceived as having a conflict of interest with her employer.

Press Office in San Diego
June 9-13, 2017
619-525-6250

Contact:
Michelle Kirkwood
(703) 299-2053
mkirkwood@diabetes.org

(PRNewsFoto/American Diabetes Association)

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SOURCE American Diabetes Association

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