Pediatric Diabetes

 The effect of impaired glucose metabolism on weight loss in multidisciplinary childhood obesity treatment
 
Objective To investigate whether children and adolescents exhibiting an impaired glucose metabolism are more obese at treatment entry and less likely to reduce their degree of obesity during treatment. Methods The present study is a longitudinal observational study, including children and adolescents from the Children's Obesity Clinic, Holbęk, Denmark. Anthropometrics, pubertal development, socioeconomic status (SES), and fasting concentrations of plasma glucose, serum insulin, serum C-peptide, and whole blood glycosylated hemoglobin (HbA1c) were collected at treatment entry and at follow-up. Proxies of Homeostasis Model Assessment 2-insulin sensitivity (HOMA2-IS) and Homeostasis Model Assessment 2-?-cell function (HOMA2-B) were calculated with the Homeostasis Model Assessment 2 program. Results In total, 569 (333 boys) patients, median 11.5?years of age (range 6-22?years), and median body mass index (BMI) z-score 2.94 (range 1.34-5.54) were included. The mean BMI z-score reduction was 0.31 (±0.46) after 13?months (range 6-18) of treatment. At treatment entry, patients with impaired estimates of glucose metabolism were more obese than normoglycemic patients. Baseline concentration of C-peptide was associated with a lower weight loss during treatment in girls (P?=?.02). Reduction in the insulin concentrations was associated with reduction in BMI z-score in both sexes (P?