Glucose metabolism disorder in obese children assessed by continuous glucose monitoring system
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Continuous glucose monitoring system (CGMS) can measure glucose levels at 5-minute intervals over a few days, and may be used to detect hypoglycemia, guide insulin therapy, and control glucose levels. This study was undertaken to assess the glucose metabolism disorder by CGMS in obese children.
Eighty-four obese children were studied. Interstitial fluid (ISF) glucose levels were measured by CGMS for 24 hours covering the time for oral glucose tolerance test (OGTT). Impaired glucose tolerance (IGT), impaired fasting glucose (IFG), type 2 diabetic mellitus (T2DM) and hypoglycemia were assessed by CGMS.
Five children failed to complete CGMS test. The glucose levels in ISF measured by CGMS were highly correlated with those in capillary samples (r=0.775, P<0.001). However, the correlation between ISF and capillary glucose levels was lower during the first hour than that in the later time period (r=0.722 vs r=0.830), and the ISF glucose levels in 69.62% of children were higher than baseline levels in the initial 1–3 hours. In 79 obese children who finished the CGMS, 2 children had IFG, 2 had IGT, 3 had IFG + IGT, and 2 had T2DM. Nocturnal hypoglycemia was noted during the overnight fasting in 11 children (13.92%).
Our data suggest that glucose metabolism disorder including hyperglycemia and hypoglycemia is very common in obese children. Further studies are required to improve the precision of the CGMS in children.
- Hannon TS, Rao G, Arslanian SA. Childhood obesity and type 2 diabetes mellitus. Pediatrics 2005;116:473–480. CrossRef
- Reinehr T, Andler W, Denzer C, Siegried W, Mayer H, Wabitsch M. Cardiovascular risk factors in overweight German children and adolescents: relation to gender, age and degree of overweight. Nutr Metab Cardiovasc Dis 2005; 15:181–187. CrossRef
- Reinehr T, Andler W, Kapellen T, Kiess W, Richter-Unruh A, Schonau E, et al. Clinical characteristics of type 2 diabetes mellitus in overweight European caucasian adolescents. Exp Clin Endocrinol Diabetes 2005;113:167–170. CrossRef
- Field AE, Cook NR, Gillman MW. Weight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood. Obes Res 2005;13:163–169. CrossRef
- Elabbassi WN, Haddad HA. The epidemic of the metabolic syndrome. Saudi Med J 2005;26:373–375.
- Pender JR, Pories WJ. Epidemiology of obesity in the United States. Gastroenterol Clin North Am 2005;34:1–7. CrossRef
- Neilson A, Schneider H. Obesity and its comorbidities: present and future importance on health status in Switzerland. Soz Praventivmed 2005;50:78–86. CrossRef
- Ehtisham S, Barrett TG, Shaw NJ. Type 2 diabetes mellitus in UK children: an emerging problem. Diabet Med 2000;17:867–871. CrossRef
- Fu JF, Liang L, Dong GP, Jiang YJ, Zou CC. Obese children with benign acanthosis nigricans and insulin resistance: analysis of 19 cases. Zhonghua Erke Zazhi 2004;42:917–919. (in Chinese)
- Sinha R, Fisch G, Teague B, Tamborlane WV, Banyas B, Allen K, et al. Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med 2002;346:802–810. CrossRef
- Csabi G, Torok K, Jeges S, Molnar D. Presence of metabolic cardiovascular syndrome in obese children. Eur J Pediatr 2000;159:91–94. CrossRef
- Cho NH, Jang HC, Park HK, Cho YW. Waist circumference is the key risk factor for diabetes in Korean women with history of gestational diabetes. Diabetes Res Clin Pract 2006; 71:177–83. CrossRef
- Matsumoto H, Nakao T, Okada T, Nagaoka Y, Iwasawa H, Tomaru R, et al. Insulin resistance contributes to obesity-related proteinuria. Intern Med 2005;44:548–553. CrossRef
- Saito T, Shimazaki Y, Kiyohara Y, Kato I, Kubo M, Iida M, et al. Relationship between obesity, glucose tolerance, and periodontal disease in Japanese women: the Hisayama study. J Periodontal Res 2005;40:346–353. CrossRef
- Urakami T, Kubota S, Nitadori Y, Harada K, Owada M, Kitagawa T. Annual incidence and clinical characteristics of type 2 diabetes in children as detected by urine glucose screening in the Tokyo metropolitan area. Diabetes Care 2005;28:1876–1881. CrossRef
- Pontiroli AE, Pizzocri P, Caumo A, Perseghin G, Luzi L. Evaluation of insulin release and insulin sensitivity through oral glucose tolerance test: differences between NGT, IFG, IGT, and type 2 diabetes mellitus. A cross-sectional and follow-up study. Acta Diabetol 2004;41:70–76.
- American Diabetes Association. Self-monitoring of blood glucose (Consensus Statement). Diabetes Care 1994;17:81–86.
- Boland E, Monsod T, Delucia M, Brandt CA, Fernando S, Tamborlane WT. Limitations of conventional methods of self-monitoring of blood glucose. Diabetes Care 2001;24:1858–1862. CrossRef
- Bode BW, Gross TM, Thornton KR, Mastrototaro JJ. Continuous glucose monitoring system used to adjust diabetes therapy improves glycosylated hemoglobin: a pilot study. Diabetes Res Clin Pract 1999;46:183–190. CrossRef
- Kaufman FR, Gibson LC, Halvorson M, Carpenter S, Fisher LK, Pitukcheewanont P. A pilot study of the continuous glucose monitoring system: clinical decisions and glycemic control after its use in pediatric type 1 diabetic subjects. Diabetes Care 2001;24:2030–2034. CrossRef
- Yogev Y, Chen R, Ben-Haroush A, Phillip M, Jovanovic L, Hod M. Continuous glucose monitoring for the evaluation of gravid women with type 1 diabetes mellitus. Obstet Gynecol 2003;101:633–638. CrossRef
- Chase HP, Kim LM, Owen SL, MacKenzie TA, Klingensmith GJ, Murtfeldt R, et al. Continuous subcutaneous glucose monitoring in children with type 1 diabetes. Pediatrics 2001;107:222–226. CrossRef
- Puavilai G, Chanprasertyotin S, Sriphrapradaeng A. Diagnostic criteria for diabetes mellitus and other categories of glucose intolerance: 1997 criteria by the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (ADA), 1998 WHO consultation criteria, and 1985 WHO criteria. World Health Organization. Diabetes Res Clin Pract 1999;44:21–26. CrossRef
- Herbst A, Roth CL, Dost AG, Fimmers R, Holl RW. Rate of hypoglycaemia and insulin dosage in children during the initial therapy of type 1 diabetes mellitus. Eur J Pediatr 2005;164:633–638. CrossRef
- Bantle JP, Thomas W. Glucose measurement in patients with diabetes mellitus with dermal interstitial fluid. J Lab Clin Med 1997;130:436–441. CrossRef
- Fischer, U. Continuous in vivo monitoring in diabetes: the subcutaneous glucose concentration. Acta Anaesthesiol Scand Suppl 1995;104:21–29. CrossRef
- Sternberg F, Meyerhoff C, Mennel FJ, Bischof F, Pfeiffer EF. Subcutaneous glucose concentration in humans. Real estimation and continuous monitoring. Diabetes Care 1995;18:1266–1269. CrossRef
- Sternberg F, Meyerhoff C, Mennel FJ, Mayer H, Bischof F, Pfeiffer EF. Does fall in tissue glucose precede fall in blood glucose? Diabetologia 1996;39:609–612. CrossRef
- Sun WX, Wang W, Wang DF, Cui YF. Oral glucose tolerance and insulin release test in 52 cases of obese and overweight children. Zhonghua Erke Zazhi 2005;43:93–95. (in Chinese)
- Wiegand S, Maikowski U, Blankenstein O, Biebermann H, Tarnow P, Gruters A. Type 2 diabetes and impaired glucose tolerance in European children and adolescents with obesity: a problem that is no longer restricted to minority groups. Eur J Endocrinol 2004;151:199–206. CrossRef
- Goran MI, Bergman RN, Avila Q, Watkins M, Ball GD, Shaibi GQ, et al. Impaired glucose tolerance and reduced β-cell function in overweight Latino children with a positive family history for type 2 diabetes. J Clin Endocrinol Metab 2004;89:207–212. CrossRef
- Edelstein SL, Knowler WC, Bain RP, Andres R, Barrett-Connor EL, Dowse GK, et al. Predictors of progression from impaired glucose tolerance to NIDDM: an analysis of six prospective studies. Diabetes 1997;46:701–710. CrossRef
- Saad MF, Knowler WC, Pettitt DJ, Nelson RG, Mott DM, Bennett PH. The natural history of impaired glucose tolerance in the Pima Indians. N Engl J Med 1988;19:1500–1506.
- Meigs JB, Muller DC, Nathan DM, Blake DR, Andres R. The natural history of progression from normal glucose tolerance to type 2 diabetes in the Baltimore Longitudinal Study of Aging. Diabetes 2003;52:1475–1484. CrossRef
- Chou P, Li CL, Wu GS, Tsai ST. Progression to type 2 diabetes among high-risk groups in Kin-Chen, Kinmen: exploring the natural history of type 2 diabetes. Diabetes Care 1998;21:1183–1187. CrossRef
- Wong MS, Gu K, Heng D, Chew SK, Chew LS, Tai ES. The Singapore impaired glucose tolerance follow-up study: does the ticking clock go backward as well as forward? Diabetes Care 2003;26:3024–3030. CrossRef
- Weiss R, Taksali SE, Tamborlane WV, Burgert TS, Savoye M, Caprio S. Predictors of changes in glucose tolerance status in obese youth. Diabetes Care 2005;28:902–909. CrossRef
- Liang L, Fu JF, Zou CC, Hong F, Wang CL. Metformin hydrochlorides ameliorates adiponectin levels and insulin sensitivity in adolescents with metabolic syndrome. Zhonghua Erke Zazhi 2006;44:118–121. (in Chinese)
- Glucose metabolism disorder in obese children assessed by continuous glucose monitoring system
World Journal of Pediatrics
Volume 4, Issue 1 , pp 26-30
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- glucose metabolism disorders
- impaired glucose tolerance
- type 2 diabetic mellitus