Endocrine Abstracts

JOINT1073

Introduction: According to the International Diabetes Federation (IDF) Position Statement, people with a 1-h G ≥ 155 mg/dL (8. 6 mmol/l) during an oGTT are considered to have intermediate hyperglycemia (IH) and people with a 1-h G ≥ 209 mg/dL (11. 6 mmol/l) are considered to have type 2 diabetes (T2D). There are few papers that analyze those findings in children/adolescents. The aim of this study is to analyze the oGTT response in adolescents with overweight/obesity and compare the frequency of IH according to fasting glucose, 1-h and 2-h post-load.

Methods: This study comprised 195 pubertal adolescents with overweight/obesity who underwent oGTT. They were classified into 3 groups: Group 1: Fasting glucose > 100 mg/dL, Group 2: 1-h post-load (1hG) ≥ 155 mg/dL and group 3: 2-h post-load PG (2hG) >140 mg/dL. The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and Oral Disposition Index (oDI) were calculated.

Results: A total of 195 curves were evaluated, 63 male and 132 female with a mean chronological age (SD) of 12. 5 years (2. 1). The mean zBMI and Waist-to-Height Ratio (WHtR) relation were 2. 7 kg/m² (0. 7) and 0. 61 (0. 06), respectively. No patient had diagnosis of T2D based on 2hG, but one patient was diagnosed as T2D after 1hG. 16 (8. 2%) patients had IFG, 10 (5. 1%) had 1hG ≥ 155 mg/dL and 8 (4. 1%) had IGT after 2hG. Compared to patients with normal oGTT, those in all 3 groups were older (P = 0. 002, 0. 022 and <0. 001, respectively), had higher HOMA-IR (P = 0. 031), but there were no differences in zBMI or waist/height ratio. Patients in groups 2 and 3, with higher 1hG and 2hG, had lower oDI value (p < 0. 05), suggesting worse β-cell function.

Conclusion: There is limited literature in adolescents indicating that an 1h post-load PG ≥ 155 mg/dL with NGT during an oGTT is highly predictive for detecting progression to T2D. However, our findings suggest worse β-cell function and that the same cut-offs could potentially be used in children/adolescents. Surprisingly, in this group of patients, the severity of obesity did not correlate with the presence of β-cell dysfunction, a fact that could be associated with duration of disease progression instead of the anthropometric parameter. Further studies are needed to confirm these findings.