Type 2 diabetes in children not always associated with obesity: JAMA

The childhood obesity epidemic is presumed to drive pediatric type 2 diabetes (T2D); however, the global scale of obesity in children with T2D is unknown.

A new study published in the Journal of American Medical Association suggests that despite being a significant risk factor for type 2 diabetes (T2D) in childhood, not all individuals with the disease have obesity.

T2D in children and adolescents has emerged over the past few decades along with an increase in pediatric obesity rates worldwide. However, it is uncertain how widespread obesity is among kids with T2D globally. The biopsychosocial determinants of health, which include health disparities and social and economic vulnerabilities in this group, have a significant impact in disease risk and outcomes even if the intricate web of variables driving the pathogenesis of pediatric T2D are not yet completely understood. This study was carried out by Milena Cioana and colleagues to estimate the global incidence of obesity in pediatric T2D, investigate the relationship between sex and race and obesity risk, and evaluate the relationship between obesity and glycemic control and dyslipidemia.

From the creation of the database through June 16, 2022, MEDLINE, CINAHL, Embase, Cochrane Library, and Web of Science were searched for this study. The frequency of obesity among patients with pediatric T2D was reported in observational studies with at least 10 participants. Data extraction, risk of bias, and level of evidence assessments were carried out by 2 independent reviewers working in teams in accordance with the Meta-analysis of Observational Studies in Epidemiology reporting guidelines. In order to conduct the meta-analysis, a random-effects model was used. The combined prevalence rates of obesity in kids with T2D were one of the main findings. The secondary outcomes evaluated the prevalence rates by sex and race, as well as the relationships between obesity, dyslipidemia, and glycemic control.

The key findings of this study were:

1. 53 publications with 8942 individuals were included in the meta-analysis out of the 57 articles that were included in the systematic review.

2. The prevalence of obesity overall among children with T2D was 75.27%, and the prevalence of obesity at the time of diabetes diagnosis was 77.24% among 4688 individuals.

3. In contrast to other racial groupings, White participants had the greatest prevalence of obesity while Asian individuals had the lowest.

4. Male participants had greater probabilities of obesity than female ones.

5. Variable levels of glycemic control and dyslipidemia as well as high variability between trials were observed.

The researchers concluded that not all pediatric patients with T2D had obesity; further studies are therefore needed to elucidate the mechanisms beyond obesity driving this condition in children.

Reference:

Cioana, M., Deng, J., Nadarajah, A., Hou, M., Qiu, Y., Chen, S. S. J., Rivas, A., Banfield, L., Toor, P. P., Zhou, F., Guven, A., Alfaraidi, H., Alotaibi, A., Thabane, L., & Samaan, M. C. (2022). The Prevalence of Obesity Among Children With Type 2 Diabetes. In JAMA Network Open (Vol. 5, Issue 12, p. e2247186). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2022.47186