OBJECTIVE: To examine whether a hemoglobin A1c (HbA1c)-identified prediabetic state (HbA1c ≥ 6.0%-6.4%) is associated with decreased insulin sensitivity (SI) and β-cell dysfunction, known factors in the pathogenesis of type 2 diabetes, in an overweight pediatric population. STUDY DESIGN: A total of 206 healthy overweight Latino adolescents (124 males and 82 females; mean age, 13.1 ± 2.0 years) were divided into 2 groups: lower risk (n=179), with HbA1c <6.0%, and higher risk (n=27), with HbA1c 6.0%-6.4%. Measurements included HbA1c, oral glucose tolerance testing, fasting and 2-hour glucose and insulin, SI, acute insulin response, and disposition index (an index of β-cell function) by the frequently sampled intravenous glucose tolerance test with minimal modeling. Body fat was determined by dual-energy X-ray absorptiometry. RESULTS: Compared with the lower risk group, the higher risk group had 21% lower SI (1.21 ± 0.06 vs 1.54 ± 0.13; P<.05), 30% lower acute insulin response (928 ± 102 vs 1342 ± 56; P<.01), and a 31% lower disposition index (1390 ± 146 vs 2023 ± 83; P=.001) after adjusting for age and total percent body fat. CONCLUSION: These data provide clear evidence of greater impairment of β-cell function in overweight Latino children with HbA1c 6.0%-6.4%, and thereby support the adoption of the International Expert Committee's HbA1c-determined definition of high-risk state for overweight children at risk for type 2 diabetes.
OBJECTIVE: To examine whether a hemoglobin A1c (HbA1c)-identified prediabetic state (HbA1c ≥ 6.0%-6.4%) is associated with decreased insulin sensitivity (SI) and β-cell dysfunction, known factors in the pathogenesis of type 2 diabetes, in an overweight pediatric population. STUDY DESIGN: A total of 206 healthy overweight Latino adolescents (124 males and 82 females; mean age, 13.1 ± 2.0 years) were divided into 2 groups: lower risk (n=179), with HbA1c <6.0%, and higher risk (n=27), with HbA1c 6.0%-6.4%. Measurements included HbA1c, oral glucose tolerance testing, fasting and 2-hour glucose and insulin, SI, acute insulin response, and disposition index (an index of β-cell function) by the frequently sampled intravenous glucose tolerance test with minimal modeling. Body fat was determined by dual-energy X-ray absorptiometry. RESULTS: Compared with the lower risk group, the higher risk group had 21% lower SI (1.21 ± 0.06 vs 1.54 ± 0.13; P<.05), 30% lower acute insulin response (928 ± 102 vs 1342 ± 56; P<.01), and a 31% lower disposition index (1390 ± 146 vs 2023 ± 83; P=.001) after adjusting for age and total percent body fat. CONCLUSION: These data provide clear evidence of greater impairment of β-cell function in overweight Latino children with HbA1c 6.0%-6.4%, and thereby support the adoption of the International Expert Committee's HbA1c-determined definition of high-risk state for overweight children at risk for type 2 diabetes.
Authors: William C Knowler; Elizabeth Barrett-Connor; Sarah E Fowler; Richard F Hamman; John M Lachin; Elizabeth A Walker; David M Nathan Journal: N Engl J Med Date: 2002-02-07 Impact factor: 91.245
Authors: Michael I Goran; Richard N Bergman; Quintilia Avila; Michael Watkins; Geoff D C Ball; Gabriel Q Shaibi; Marc J Weigensberg; Martha L Cruz Journal: J Clin Endocrinol Metab Date: 2004-01 Impact factor: 5.958
Authors: Andreas Festa; Ralph D'Agostino; Anthony J G Hanley; Andrew J Karter; Mohammed F Saad; Steven M Haffner Journal: Diabetes Date: 2004-06 Impact factor: 9.461
Authors: Tanya L Alderete; Claudia M Toledo-Corral; Preeya Desai; Marc J Weigensberg; Michael I Goran Journal: J Clin Endocrinol Metab Date: 2013-07-19 Impact factor: 5.958
Authors: Claudia M Toledo-Corral; Tanya L Alderete; Joyce Richey; Paola Sequeira; Michael I Goran; Marc J Weigensberg Journal: Acta Diabetol Date: 2014-08-11 Impact factor: 4.280
Authors: Stephen F Burns; SoJung Lee; Fida Bacha; Hala Tfayli; Tamara S Hannon; Silva A Arslanian Journal: Metabolism Date: 2014-08-27 Impact factor: 8.694
Authors: Marc J Weigensberg; Quintila Àvila; Donna Spruijt-Metz; Jaimie N Davis; Cheng K F Wen; Kim Goodman; Marisa Perdomo; Niquelle Brown Wadé; Li Ding; Christianne J Lane Journal: J Altern Complement Med Date: 2021-05-25 Impact factor: 2.381
Authors: Stephanie Hsieh; Ann C Klassen; Frank C Curriero; Laura E Caulfield; Lawrence J Cheskin; Jaimie N Davis; Michael I Goran; Marc J Weigensberg; Donna Spruijt-Metz Journal: Prev Med Rep Date: 2015
Authors: Lauren E Gyllenhammer; Marc J Weigensberg; Donna Spruijt-Metz; Hooman Allayee; Michael I Goran; Jaimie N Davis Journal: Obesity (Silver Spring) Date: 2013-09-20 Impact factor: 5.002