Compared with children with normal weight, children with obesity are four times more likely to develop incident type 2 diabetes before reaching adulthood, according to findings published in the Journal of the Endocrine Society.
“As the prevalence of obesity and being overweight has rapidly risen, an increasing number of children and young adults have been diagnosed with diabetes in the United Kingdom since the early 1990s,” Ali Abbasi, MD, PhD, of King’s College London, United Kingdom, said in a press release. “A child with obesity faces a fourfold greater risk of being diagnosed with diabetes by age 25 than a counterpart who is normal weight.”
Abbasi and colleagues analyzed electronic health records from 369,361 children aged 2 to 15 years (49.5% girls) using the U.K. Clinical Practice Research Datalink, which pulls data from 375 general practices. Researchers assessed demographic information, BMI (converted to z scores) and diabetes diagnosis records between 1994 and 2013. The mean age on last birthday before BMI score was 9 years; median BMI z score was 0.36; 12.3% had overweight, and 16.7% had obesity.
Within the cohort, there were 654 incident cases of type 2 diabetes and 1,318 incident cases of type 1 diabetes occurring between 1994 and 2013. Cases of type 2 diabetes per 100,000 persons per year increased from 6.4 in 1994-1998 to 33.2 in 2009-2013. Cases of type 2 diabetes increased from 38.2 to 52.1 per 100,000 over the same period.
Children with obesity had substantially higher incidence rates of type 2 diabetes compared with those with normal BMI, with an adjusted incidence rate ratio of 4.3 (95% CI, 3.7-5.1); higher rates of type 2 diabetes were especially marked in those with obesity aged 11 to 15 years and in the last two periods (P for interaction < .01).
In nested, case-control analysis, researchers found that children with obesity made up 47% of type 2 diabetes cases and had approximately four times the risk for incident type 2 diabetes vs. those with a normal BMI (OR = 3.7; 95% CI, 3.1-4.6). Using BMI as a continuous variable, researchers observed a 1.6-fold increase per 1 standard deviation increase in BMI z score (95% CI, 1.5-1.7). Researchers did not observe any association between obesity and incident type 1 diabetes.
“Diabetes imposes a heavy burden on society because the condition is common and costly to treat,” Abbasi said in the release. “Estimates indicate one in 11 adults has type 2 diabetes, or about 415 million people worldwide. Given that diabetes and obesity are preventable from early life, our findings and other research will hopefully motivate the public and policymakers to invest and engage in diabetes prevention efforts.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.