None of the authors had any personal or financial conflict of interest.
EAA, principal investigator, participated in the study design, recruitment of subjects, examination, data collection and drafting of the manuscript. GD participated in the study design, performance of statistical calculations, creation of the graphs and drafting of the manuscript. MA participated in data management, analysis and performance of statistical calculations. EAZ was responsible for collaboration with the different schools and participated in examination, data collection and data entry. NAB participated in data entry. MP participated in examination, data collection and data entry. AA participated in drafting of the manuscript. All authors read and approved the final manuscript.
The aim of the study was to estimate the prevalence of prediabetes and type 2 diabetes (T2D) among overweight/obese children and adolescents using different diagnostic/screening methods in comparison.
We recruited overweight/obese Emirati students; grade 6–12 (age 11–17 years) from 16 government schools in Sharjah (UAE). Anthropometric, demographic, and clinical history data was measured by standard methods. Body mass index (BMI) was categorized according to BMI percentile charts for age and sex – CDC. Capillary fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) were measured by finger prick test, followed by confirmatory oral glucose tolerance tests (OGTT) and venous HbA1c for students with abnormal capillary FBG and/or HbA1c.
Of a total of 1034 participants (45 % females) median age 14.7 years, 443 (43 %) students had abnormal screening results. The prevalence of prediabetes and T2D was 5.4 % and 0.87 %, respectively, based on OGTT (gold standard). HbA1c showed a considerable discrepancy regarding the prevalence of prediabetes (21.9 %), but not diabetes. There was a statistically significant difference in the BMI Z-scores between the three different groups of students showing normal glycemic testing, prediabetes and T2D (p = 0.041). Univariate logistic regression analysis showed that glycemic status was significantly associated with family history of T2D first-degree relatives [OR 1.87: 95 % CI: 1.04–3.36; P = 0.036], parents employment [OR 1.79: 95 % CI: 1.06–3.02; P = 0.029] and levels of triglycerides [OR 2.28: 95 % CI: 1.11–4.68; P = 0.024].
The prevalence of prediabetes and diabetes was high among overweight/obese Emirati children and adolescents. The numbers for prediabetes were considerably higher when using HbA1c as compared to OGTT. Overall adiposity, family history of T2D, employment and high levels of triglycerides were risk factors associated with abnormal glycemic testing.