Prevalence of Type 2 diabetes and pre‐diabetes among overweight or obese children in Tianjin, China

Abstract

To determine the prevalence of Type 2 diabetes and pre-diabetes and their risk factors among overweight or obese school children aged 7-18 years in Tianjin, China. A cross-sectional survey in a representative sample of overweight/obese children or adolescents in Tianjin was conducted from May to August 2010 using a stratified cluster sampling method. A two-step screening, which was conducted to identify Type 2 diabetes and pre-diabetes in these children, consisted of a fasting capillary glucose test and a standard 2-h oral glucose tolerance test. Subjects who had fasting capillary glucose ≥ 5.6 mmol/l were invited for an oral glucose tolerance test. The study used Chinese criteria for classification of obesity/overweight and World Health Organization criteria for diabetes/pre-diabetes. A total of 3173 children participated in the survey, with a response rate of 99.0%. Of the children, 13.0% (n = 413) were overweight and 15.4% (n = 490) were obese. Among these 903 children, 727 (80.5%) agreed to and underwent the diabetes screening and two (0.28%) were diagnosed as having Type 2 diabetes, six (0.83%) to have impaired fasting glucose, 16 (2.20%) to have impaired glucose tolerance and two (0.28%) to have both. The prevalence of Type 2 diabetes and pre-diabetes was 0.28% (95% CI 0.08-1.00%) and 3.30% (95% CI 2.23-4.87%), respectively. Abdominal obesity and motorized commuting were associated with Type 2 diabetes or pre-diabetes among overweight or obese boys, while high birthweight was associated with Type 2 diabetes or pre-diabetes among girls. Type 2 diabetes among school-aged children was still low in Tianjin, China. However, Type 2 diabetes-related factors were very common, especially overweight and obesity.