Risk of Type 2 Diabetes Skyrockets in Severely Obese Children

Severe obesity in childhood causes a dangerously elevated risk of develping type 2 diabetes (T2D) by young adulthood, according to a study presented at the American Diabetes Association (ADA)’s 77th Scientific Session in San Diego, California.

The study, “Long-term Risk of Type 2 Diabetes in Youth with Increasing Severity of Obesity," showed that severely obese American Indian children between the ages of 5 and 9 had a 12-times greater risk of developing T2D by age 20 as normal-weight youth in the same age group.

“We had previously found BMI in youth to be a strong predictor of type 2 diabetes, but we had not examined diabetes incidence rates in those with the severe degree of obesity that is prevalent today,” Madhumita Sinha, MD, MHSM, staff clinician at the Diabetes Epidemiology and Clinical Research Section of the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health, said in a press release. “We did not know if diabetes incidence rates among the obese plateaued among those with extremely high BMI. This study clearly shows that the risk of developing type 2 diabetes is associated with BMI, especially at very high extremes.”

The CDC classifies obesity as being at or above a cut point that is specified as the 95th body mass index (BMI) percentile. Prior research shows a strong correlation between BMI and T2D incidence in adults and adolescents, but these studies did not assess the long-term risk in youths with extremely high BMIs.

The current study analyzed the risk of developing diabetes and other metabolic abnormalities in obese and severely obese American Indian children from the southwestern United States, which has a population at high risk of developing T2D, according to the study authors. Incidence was evaluated in 2728 children without diabetes between the ages of 5 and 9, and a partially overlapping group of 4317 youths between the ages of 10 and 17. The groups were followed unitl age 45 or until onset of T2D. Age- and sex-specific BMI percentiles were defined by the CDC’s 2000 growth charts.

Compared with non-obese children aged 5 to 9 who had BMIs in the middle of the distribution, children of the same age with BMIs at least 40% higher than the defined obesity cut point had 12 times the incidence rates of T2D by age 20, and 3 times the incidence by age 45.

“Parents and healthcare providers should be aware of the future diabetes risk associated with obesity in youth, especially as more severe degrees of obesity become more prevalent,” Sinha said. “Results of our analysis emphasize the importance of developing effective means of preventing or treating obesity in youth, and additional risk factors for type 2 diabetes in youth should be explored for their interactions with severe obesity.”