The presence of family history and the development of type 2 diabetes mellitus risk factors in rural children

Prevalence of type 2 diabetes risk factors, including overweight and obesity, among youth attending hospital-based paediatric care in Western Melbourne

AIM

To determine the prevalence of risk factors for type 2 diabetes in overweight and obese adolescents attending hospital-based paediatric care in Western Melbourne.

METHODS

One hundred overweight and obese adolescents (aged 10-17 years) who attended an outpatient clinic at Sunshine Hospital between May 2019 and May 2020 were randomly selected following a retrospective chart review of 10-17 years old for whom a height and weight had been documented. Additional risk factors for type 2 diabetes were ascertained via structured telephone interview. Data were analysed to determine the overall prevalence of risk factors for type 2 diabetes, and to evaluate for associations between each parameter with body mass index and the number of risk factors.

RESULTS

Of the 487 adolescents who had height and weight data recorded, 45% were overweight or obese. 77% of those who were interviewed had an additional risk factor for type 2 diabetes. No association between the number of risk factors and body mass index standard deviation score was found. Additionally, there was no association between the number of risk factors for type 2 diabetes and either family history of type 2 diabetes or ethnicity.

CONCLUSIONS

This paediatric subpopulation had a high rate of risk factors for type 2 diabetes in addition to overweight and obesity, and are at risk of premature mortality and chronic morbidity should they develop type 2 diabetes.

Exploring the Prevalence of Undiagnosed Prediabetes, Type 2 Diabetes Mellitus, and Risk Factors in Adolescents: A Systematic Review

PROBLEM

The prevalence of prediabetes and type 2 diabetes (T2D) is increasing in adolescents worldwide. Most studies have focused on the clinical features, treatment, and complications for adolescents and so the need to generate insight into the risk factors and prevalence of undiagnosed prediabetes and T2D in adolescents across the globe remains.

ELIGIBILITY CRITERIA

Relevant articles that were published from 2007 up to and including January 2017 were identified through electronic searches of CINAHL, Cochrane, Medline, PsycInfo, PubMed, Scopus, Web of Science, and Sociological Abstracts (Proquest). Four independent researchers examined the articles for eligibility.

SAMPLE

Sixteen studies were included that investigated the risk and prevalence of undiagnosed prediabetes and T2D in adolescents aged 12-19.

RESULTS

The most commonly measured risk factors included obesity/overweight, family history, and ethnicity. Other studies measured risk factors associated with insulin resistance, including hypertension, acanthosis nigricans, and dyslipidemia. Prevalence of undiagnosed prediabetes and T2D varied among regions globally with rates ranging from 3.3 to 14.3% and 0.1 to 2.2%, respectively.

CONCLUSIONS

Undiagnosed prediabetes and T2D and the associated risk factors are prevalent in many regions in countries worldwide, significantly impacting adolescents and their families.

IMPLICATIONS

Future research is required to inform interventions aimed at preventative measures for early screening and detection of prediabetes and T2D in adolescents, as well as the development of multi-disciplinary teams that include pediatric nurses and the specialized care they provide.

Comparing child health, access to care, and utilization of health services between Ohio Appalachia's River and non-river bordering counties

Appalachia's River and non-River Bordering Counties. Children living in Ohio's Appalachian counties that border the Ohio River are disproportionally exposed to adverse environmental conditions prevalent along the river that may contribute to disparities in health, access to care and care utilization. This study examined if there were differences in health, access to care and care utilization between Ohio's Appalachian children living in counties that border the Ohio River and those living in counties that do not border the river. A secondary analysis of the 28 Appalachian counties from Ohio's 88 counties included in the 2008 Ohio Family Health Survey was conducted using a Bayesian Hierarchical Modeling strategy. Descriptive analyses comparing geographic groups across demographic, health, access, utilization, and health insurance also were conducted. Childhood asthma was more prevalent in the river-bordering counties (16.4%) compared to the non-river counties (9.4%). Children with asthma had more sere symptoms in the river bordering counties (8.2%) compared to the non-river bordering counties (4.4%). Children residing in river bordering counties had higher rates of obesity (24.4%) and overweight (17%). After controlling for child health and insurance status, children living in the river bordering counties had less access to care (est. -7.14, CI = -17.3,0.74) and more difficulty accessing specialty care. Children residing in the non-river counties had more sickness care utilization (est. 0.25, CI = 0.01, 0.49). Regardless of region, children with a regular health care provider and place for care were healthier. Differences in child health, access to care and utilization of services exist within Ohio's Appalachian region.

Health status and access to health care services: a comparison between Ohio's rural non-Appalachian and Appalachian families

Comparisons in the health status of rural dwellers and care access have not traditionally considered culturally defined areas such as Appalachia. This study examined differences in parent health status, child health status, and access to care between those living in Ohio's 29 Appalachian counties and those living in Ohio's 30 rural counties. We analyzed data from the 2008 Ohio Family Health Survey including Bayesian hierarchical modeling. Child health differed by gender and ethnicity. Parent health status differed by region. Parent and child health status were related to care access. Health and access disparities exist within rural and Appalachia Ohio.

Fatores de risco para diabetes mellitus tipo 2 entre adolescentes

O estudo teve como objetivo identificar fatores de risco para diabetes tipo 2 (DM 2) em uma população de adolescentes de escolas particulares de Fortaleza, Brasil. Foram avaliados 794 alunos, de 12 a 17 anos, em doze escolas, nos meses de maio, junho, agosto e setembro de 2007. Aplicou-se um formulário abordando aspectos sociodemográficos, IMC, pressão arterial, glicemia capilar e sedentarismo. Aproximadamente 24% dos participantes tinham o IMC elevado, 65% eram sedentários e 51% tinham antecedentes familiares de DM 2. Naqueles com maior renda, 73,5% tinham antecedentes familiares de DM 2 (p=0,04). Por volta de 39% dos adolescentes apresentavam pelo menos dois fatores de risco para DM 2. A maior parte dos fatores de risco para DM 2, identificados neste estudo, são modificáveis, portanto passíveis de intervenções preventivas no contexto escolar.

Risk Factors for Type 2 Diabetes Mellitus in Children

This study investigates risk factors for type 2 diabetes mellitus in a population of children in public schools, Fortaleza, CE, Brazil. A total of 727 children aged 6 to 11 years old from 12 schools were evaluated between March and June 2008. A form addressing socio-demographic data, body mass index, blood pressure, capillary blood glucose and waist circumference was applied. A total of 54.1% of the children were female, 21.7% were overweight, 6.6% were obese, 27% had central obesity, 6.2% showed altered capillary glucose, and 17% high blood pressure. In relation to risk factors, 53.4% presented no risk factors; 24.3% had at least one factor and 18.8% two risk factors. Nurses can intervene in schools through educational health programs encouraging the adoption of healthy habits and identifying children at risk of type 2 diabetes mellitus.

Acanthosis nigricans among Northern Plains American Indian children

The purpose of this study is to present cross-sectional and prospective data on acanthosis nigricans (AN) prevalence in the context of other risk factors for diabetes including high body mass index (BMI), abnormal blood pressure (BP), physical inactivity and family history of diabetes among Northern Plains American Indian (AI) children. Standardized health measures were collected in 2,520 K-12th-grade AI students for AN, BMI, and BP. Data were also collected on family history of diabetes and physical activity. Approximately, 9.7% of the participants were positive for AN. AN was associated with high BMI, abnormal BP, and diabetes family history. Sports participation was inversely associated with AN. Among children measured the prior year, relative risk (and 95% confidence interval [CI]) for obesity and incident AN was 9.8 (4.2-23.0) compared to normal weight. These findings suggest there is utility in measuring this marker of insulin resistance in this at-risk population.