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Childhood obesity quadruples risk of type 2 diabetes, study finds

By Nicole MacKee
The growing rate of childhood obesity is fuelling an increase in type 2 diabetes among UK children, say researchers who have found a fourfold greater risk of diabetes in obese children.

A retrospective cohort study of 369,362 children aged 2 to 15 years between 1994 and 2013 identified 654 incident cases of type 2 diabetes, and 1318 cases of type 1 diabetes.

The study, published in the Journal of the Endocrine Society, found an increasing incidence in both type 1 and type 2 diabetes over the study period. However, only type 2 diabetes was shown to have a linear association with obesity (those ≥95th percentile for age- and sex-specific body mass index [BMI]), with an incidence rate ratio for type 2 diabetes of 4.33 (95% confidence interval, 3.68–5.08) compared with those in the normal BMI category.

Professor Fergus Cameron, group leader at the Murdoch Children’s Research Institute, and consultant endocrinologist in the Department of Endocrinology and Diabetes at The Royal Children’s Hospital in Melbourne, said the incidence of type 2 diabetes had a strong linkage to the ethnic makeup of a population, with variations in risk occurring in different parts of the world and within countries.

‘It’s a very nuanced story, and it depends very heavily on the ethnicity of the society. Back in the early 2000s, everyone was bracing themselves for an epidemic of type 2 diabetes in youth, and it just never came to pass [in Australia],’ said Professor Cameron, adding that Australia’s ethnic mix was now very different to that of the UK, where there was a much higher population of people of south Asian origin.

Professor Cameron pointed to 2010 research, of which he was a coauthor, that identified only 33 cases of type 2 diabetes after intensive screening of more than 1500 children presenting to a tertiary diabetes service in Australia over six years. [Ruhayel SD, et al. Paediatr Diabetes 2010; 11: 544-551.]

‘[In overweight children], it’s still more common to have type 1 than type 2 diabetes in Melbourne right now,’ Professor Cameron told Endocrinology Today.

However, he added, the risk of paediatric type 2 diabetes varied across Australia, with parts of Western Australia reporting higher rates than Victoria, reflecting higher rates of type 2 diabetes seen in Indigenous adolescents.

‘There appears to be very strong ethnic linkage to risk of type 2 diabetes with obesity, with adolescents from Indigenous populations and Hispanic, Islander, south Asian and African-American communities seemingly at higher risk,’ Professor Cameron said.
J Endocr Soc 2017; 1: 524-537.

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