Skip to main content
Top
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

The prevalence, risk factors, and screening measure for prediabetes and diabetes among Emirati overweight/obese children and adolescents

Authors: Elham Al Amiri, Mona Abdullatif, Abdishakur Abdulle, Nibal Al Bitar, Elham Zaki Afandi, Monira Parish, Gassan Darwiche

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

The aim of the study was to estimate the prevalence of prediabetes and type 2 diabetes (T2D) among overweight/obese children and adolescents using different diagnostic/screening methods in comparison.

Methods

We recruited overweight/obese Emirati students; grade 6–12 (age 11–17 years) from 16 government schools in Sharjah (UAE). Anthropometric, demographic, and clinical history data was measured by standard methods. Body mass index (BMI) was categorized according to BMI percentile charts for age and sex – CDC. Capillary fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) were measured by finger prick test, followed by confirmatory oral glucose tolerance tests (OGTT) and venous HbA1c for students with abnormal capillary FBG and/or HbA1c.

Results

Of a total of 1034 participants (45 % females) median age 14.7 years, 443 (43 %) students had abnormal screening results. The prevalence of prediabetes and T2D was 5.4 % and 0.87 %, respectively, based on OGTT (gold standard). HbA1c showed a considerable discrepancy regarding the prevalence of prediabetes (21.9 %), but not diabetes. There was a statistically significant difference in the BMI Z-scores between the three different groups of students showing normal glycemic testing, prediabetes and T2D (p = 0.041). Univariate logistic regression analysis showed that glycemic status was significantly associated with family history of T2D first-degree relatives [OR 1.87: 95 % CI: 1.04–3.36; P = 0.036], parents employment [OR 1.79: 95 % CI: 1.06–3.02; P = 0.029] and levels of triglycerides [OR 2.28: 95 % CI: 1.11–4.68; P = 0.024].

Conclusions

The prevalence of prediabetes and diabetes was high among overweight/obese Emirati children and adolescents. The numbers for prediabetes were considerably higher when using HbA1c as compared to OGTT. Overall adiposity, family history of T2D, employment and high levels of triglycerides were risk factors associated with abnormal glycemic testing.
Literature
1.
go back to reference Pontiroli AE. Type 2 diabetes mellitus is becoming the most common type of diabetes in school children. Acta Diabetol. 2004;41(3):85–90.CrossRefPubMed Pontiroli AE. Type 2 diabetes mellitus is becoming the most common type of diabetes in school children. Acta Diabetol. 2004;41(3):85–90.CrossRefPubMed
2.
go back to reference Malik M, Bakir A. Prevalence of overweight and obesity among children in the United Arab Emirates. Obes Rev. 2007;8(1):15–20.CrossRefPubMed Malik M, Bakir A. Prevalence of overweight and obesity among children in the United Arab Emirates. Obes Rev. 2007;8(1):15–20.CrossRefPubMed
3.
go back to reference Freedman DS, Dietz WH, Srinivasan SR, Berenson GS. The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics. 1999;103(6 Pt 1):1175–82.CrossRefPubMed Freedman DS, Dietz WH, Srinivasan SR, Berenson GS. The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics. 1999;103(6 Pt 1):1175–82.CrossRefPubMed
4.
go back to reference Wang G, Dietz WH. Economic burden of obesity in youths aged 6 to 17 years. Pediatrics. 2002;109(5):81–1.CrossRef Wang G, Dietz WH. Economic burden of obesity in youths aged 6 to 17 years. Pediatrics. 2002;109(5):81–1.CrossRef
5.
go back to reference Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350(23):2362–74.CrossRefPubMed Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350(23):2362–74.CrossRefPubMed
6.
go back to reference Ng SW, Zaghloul S, Ali HI, Harrison G, Popkin BM. The prevalence and trends of overweight, obesity and nutrition-related non-communicable diseases in the Arabian Gulf States. Obes Rev. 2001;12(1):1–13.CrossRef Ng SW, Zaghloul S, Ali HI, Harrison G, Popkin BM. The prevalence and trends of overweight, obesity and nutrition-related non-communicable diseases in the Arabian Gulf States. Obes Rev. 2001;12(1):1–13.CrossRef
7.
go back to reference Asfour MG, Lambourne A, Soliman A, Al-Behlani S, Al-Asfoor D, Bold A, et al. High prevalence of diabetes mellitus and impaired glucose tolerance in the Sultanate of Oman: results of the 1991 national survey. Diabet Med. 1995;12(12):1122–5.CrossRefPubMed Asfour MG, Lambourne A, Soliman A, Al-Behlani S, Al-Asfoor D, Bold A, et al. High prevalence of diabetes mellitus and impaired glucose tolerance in the Sultanate of Oman: results of the 1991 national survey. Diabet Med. 1995;12(12):1122–5.CrossRefPubMed
8.
go back to reference Al-Nuaim AR. Prevalence of glucose intolerance in urban and rural communities in Saudi Arabia. Diabet Med. 1997;14(7):595–602.CrossRefPubMed Al-Nuaim AR. Prevalence of glucose intolerance in urban and rural communities in Saudi Arabia. Diabet Med. 1997;14(7):595–602.CrossRefPubMed
9.
go back to reference Abdella N, Khogali M, Al-Ali S, Gumaa K, Bajaj J. Known type 2 diabetes mellitus among the Kuwaiti population, a prevalence study. Acta Diabetol. 1996;33(2):145–9.CrossRefPubMed Abdella N, Khogali M, Al-Ali S, Gumaa K, Bajaj J. Known type 2 diabetes mellitus among the Kuwaiti population, a prevalence study. Acta Diabetol. 1996;33(2):145–9.CrossRefPubMed
10.
go back to reference Moussa MA, Alsaeid M, Abdella N, Refai TM, Al-Sheikh N, Gomez JE. Prevalence of type 2 diabetes mellitus among Kuwaiti children and adolescents. Med Princ Pract. 2008;17:270–5.CrossRefPubMed Moussa MA, Alsaeid M, Abdella N, Refai TM, Al-Sheikh N, Gomez JE. Prevalence of type 2 diabetes mellitus among Kuwaiti children and adolescents. Med Princ Pract. 2008;17:270–5.CrossRefPubMed
11.
go back to reference Bin Zaal AA, Musaiger AO, D’Souza R. Dietary habits associated with obesity among adolescents in Dubai, United Arab Emirates. Nutr Hosp. 2009;24(4):437–44.PubMed Bin Zaal AA, Musaiger AO, D’Souza R. Dietary habits associated with obesity among adolescents in Dubai, United Arab Emirates. Nutr Hosp. 2009;24(4):437–44.PubMed
12.
go back to reference Punnose J, Agarwal MM, Bin-Uthman S. Type 2 diabetes mellitus among children and adolescents in Al-Ain: a case series. East Mediterr Health J. 2005;11(4):788–97.PubMed Punnose J, Agarwal MM, Bin-Uthman S. Type 2 diabetes mellitus among children and adolescents in Al-Ain: a case series. East Mediterr Health J. 2005;11(4):788–97.PubMed
13.
go back to reference Robinson D. Killing me sweetly. Arabian Business-Health. 2005;6:48–53. Robinson D. Killing me sweetly. Arabian Business-Health. 2005;6:48–53.
14.
go back to reference Bloomgarden ZT. Type 2 diabetes in the young: the evolving epidemic. Diabetes Care. 2004;27(4):998–1010.CrossRefPubMed Bloomgarden ZT. Type 2 diabetes in the young: the evolving epidemic. Diabetes Care. 2004;27(4):998–1010.CrossRefPubMed
16.
go back to reference Lee JM, Eason A, Nelson C, Kazzi NG, Cowan AE, Tarini BA. Screening practices for identifying type 2 diabetes in adolescents. J Adolesc Health. 2014;54(2):139–43.CrossRefPubMed Lee JM, Eason A, Nelson C, Kazzi NG, Cowan AE, Tarini BA. Screening practices for identifying type 2 diabetes in adolescents. J Adolesc Health. 2014;54(2):139–43.CrossRefPubMed
17.
go back to reference Agardh C-D, Berne C, Carlgren G, Olsson B, Blohmé G, Adamsson U, et al. National Guidelines for Treatment of Diabetes Mellitus. Sweden: Swedish National Board of Health and Welfare; 1999. Agardh C-D, Berne C, Carlgren G, Olsson B, Blohmé G, Adamsson U, et al. National Guidelines for Treatment of Diabetes Mellitus. Sweden: Swedish National Board of Health and Welfare; 1999.
18.
go back to reference Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, et al. CDC Growth Charts for the United States: methods and development. Vital Health Stat 11. 2000;2002(246):1–190. Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, et al. CDC Growth Charts for the United States: methods and development. Vital Health Stat 11. 2000;2002(246):1–190.
19.
go back to reference O’Brien E, Beevers G, Lip GY. ABC of hypertension: Blood pressure measurement: Part IV-Automated sphygmomanometry: self blood pressure measurement. BMJ. 2001;322(7295):1167–70.CrossRefPubMedPubMedCentral O’Brien E, Beevers G, Lip GY. ABC of hypertension: Blood pressure measurement: Part IV-Automated sphygmomanometry: self blood pressure measurement. BMJ. 2001;322(7295):1167–70.CrossRefPubMedPubMedCentral
20.
go back to reference Falkner B, Daniels SR. Summary of the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Hypertension. 2004;44(4):387–8.CrossRefPubMed Falkner B, Daniels SR. Summary of the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Hypertension. 2004;44(4):387–8.CrossRefPubMed
21.
go back to reference Pinhas-Hamiel O, Zeitler P. The global spread of type 2diabetes mellitus in children and adolescents. J Pediatr. 2005;146(5):693–700.CrossRefPubMed Pinhas-Hamiel O, Zeitler P. The global spread of type 2diabetes mellitus in children and adolescents. J Pediatr. 2005;146(5):693–700.CrossRefPubMed
22.
go back to reference Al Junaibi A, Abdulle A, Sabri S, Hag-Ali M, Nagelkerke N. The prevalence and potential determinants of obesity among school children and adolescents in Abu Dhabi, United Arab Emirates. Int J Obes (Lond). 2013;37(1):68–74.CrossRef Al Junaibi A, Abdulle A, Sabri S, Hag-Ali M, Nagelkerke N. The prevalence and potential determinants of obesity among school children and adolescents in Abu Dhabi, United Arab Emirates. Int J Obes (Lond). 2013;37(1):68–74.CrossRef
23.
go back to reference Punnose J, Agarwal MM, El Khadir A, Devadas K, Mugamer IT. Childhood and adolescent diabetes mellitus in Arabs residing in the United Arab Emirates. Diabetes Res Clin Pract. 2002;55:29–33.CrossRefPubMed Punnose J, Agarwal MM, El Khadir A, Devadas K, Mugamer IT. Childhood and adolescent diabetes mellitus in Arabs residing in the United Arab Emirates. Diabetes Res Clin Pract. 2002;55:29–33.CrossRefPubMed
24.
go back to reference El-Hazmi MAF, Warsy AS, Al-Swailem AR, Al-Swailem AM, Sulaimani R. Diabetes mellitus as a health problem in Saudi Arabia and its complications. Eastern Mediterr Health J. 1998;4:58–67. El-Hazmi MAF, Warsy AS, Al-Swailem AR, Al-Swailem AM, Sulaimani R. Diabetes mellitus as a health problem in Saudi Arabia and its complications. Eastern Mediterr Health J. 1998;4:58–67.
25.
go back to reference Sinha R, Fisch G, Teague B, Tamborlane WV, Banyas B, Allen K, et al. Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med. 2002;346(11):802–10.CrossRefPubMed Sinha R, Fisch G, Teague B, Tamborlane WV, Banyas B, Allen K, et al. Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med. 2002;346(11):802–10.CrossRefPubMed
26.
go back to reference American Diabetes Association. Type 2 diabetes in children and adolescents. Pediatrics. 2000;105(3 Pt 1):671–80.CrossRef American Diabetes Association. Type 2 diabetes in children and adolescents. Pediatrics. 2000;105(3 Pt 1):671–80.CrossRef
27.
go back to reference American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2006;Suppl. 1:S4–42. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2006;Suppl. 1:S4–42.
28.
go back to reference American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2010;Suppl. 1:S11–61.CrossRef American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2010;Suppl. 1:S11–61.CrossRef
29.
go back to reference Nowicka P, Santoro N, Liu H, Lartaud D, Shaw MM, Goldberg R, et al. Utility of hemoglobin A(1c) for diagnosing prediabetes and diabetes in obese children and adolescents. Diabetes Care. 2011;6:1306–11.CrossRef Nowicka P, Santoro N, Liu H, Lartaud D, Shaw MM, Goldberg R, et al. Utility of hemoglobin A(1c) for diagnosing prediabetes and diabetes in obese children and adolescents. Diabetes Care. 2011;6:1306–11.CrossRef
30.
go back to reference Lee JM, Gebremariam A, Wu EL, LaRose J, Gurney JG. Evaluation of nonfasting tests to screen for childhood and adolescent dysglycemia. Diabetes Care. 2011;34(12):2597–602.CrossRefPubMedPubMedCentral Lee JM, Gebremariam A, Wu EL, LaRose J, Gurney JG. Evaluation of nonfasting tests to screen for childhood and adolescent dysglycemia. Diabetes Care. 2011;34(12):2597–602.CrossRefPubMedPubMedCentral
31.
go back to reference Nowicka P, Santoro N, Liu H, Lartaud D, Shaw MM, Goldberg R, et al. Utility of hemoglobin A(1c) for diagnosing prediabetes and diabetes in obese children and adolescents. Diabetes Care. 2011;34(6):1306–11.CrossRefPubMedPubMedCentral Nowicka P, Santoro N, Liu H, Lartaud D, Shaw MM, Goldberg R, et al. Utility of hemoglobin A(1c) for diagnosing prediabetes and diabetes in obese children and adolescents. Diabetes Care. 2011;34(6):1306–11.CrossRefPubMedPubMedCentral
32.
go back to reference Lee JM, Wu EL, Tarini B, Herman WH, Yoon E. Diagnosis of diabetes using hemoglobin A1c: should recommendations in adults be extrapolated to adolescents? J Pediatr. 2011;158(6):947–52.CrossRefPubMed Lee JM, Wu EL, Tarini B, Herman WH, Yoon E. Diagnosis of diabetes using hemoglobin A1c: should recommendations in adults be extrapolated to adolescents? J Pediatr. 2011;158(6):947–52.CrossRefPubMed
33.
34.
go back to reference Selvin E, Michael Steffes W, Gregg E, Brancati FL, Coresh J. Performance of A1C for the classification and prediction of diabetes. Diabetes Care. 2011;34:84–9.CrossRefPubMed Selvin E, Michael Steffes W, Gregg E, Brancati FL, Coresh J. Performance of A1C for the classification and prediction of diabetes. Diabetes Care. 2011;34:84–9.CrossRefPubMed
35.
go back to reference DECODE study group. Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data. BMJ. 1998;317:371–5.CrossRef DECODE study group. Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data. BMJ. 1998;317:371–5.CrossRef
36.
go back to reference Greig F, Hyman S, Wallach E, Hildebrandt T, Rapaport R. Which obese youth are at increased risk for type 2 diabetes? Latent class analysis and comparison with diabetes youth. Pediatr Diabetes. 2012;13(2):181–8.CrossRefPubMed Greig F, Hyman S, Wallach E, Hildebrandt T, Rapaport R. Which obese youth are at increased risk for type 2 diabetes? Latent class analysis and comparison with diabetes youth. Pediatr Diabetes. 2012;13(2):181–8.CrossRefPubMed
37.
go back to reference Harrison TA, Hindorff LA, Kim H, Wines RC, Bowen DJ, McGarth BB, et al. Family history of diabetes as a potential public health tool. Am J Prev Med. 2003;24(2):152–9.CrossRefPubMed Harrison TA, Hindorff LA, Kim H, Wines RC, Bowen DJ, McGarth BB, et al. Family history of diabetes as a potential public health tool. Am J Prev Med. 2003;24(2):152–9.CrossRefPubMed
38.
go back to reference Solano M, Goldberg R. Lipid management in type 2 diabetes. Clinical Diabetes. 2006;24:27–32.CrossRef Solano M, Goldberg R. Lipid management in type 2 diabetes. Clinical Diabetes. 2006;24:27–32.CrossRef
39.
go back to reference Weiss R, Dufour S, Taksali SE, Tamborlane WV, Petersen KF, Bonadonna RC, et al. Prediabetes in obese youth: a syndrome of impaired glucose tolerance, severe insulin resistance, and altered myocellular and abdominal fat partitioning. Lancet. 2003;362(9388):951–7.CrossRefPubMedPubMedCentral Weiss R, Dufour S, Taksali SE, Tamborlane WV, Petersen KF, Bonadonna RC, et al. Prediabetes in obese youth: a syndrome of impaired glucose tolerance, severe insulin resistance, and altered myocellular and abdominal fat partitioning. Lancet. 2003;362(9388):951–7.CrossRefPubMedPubMedCentral
40.
go back to reference Garza C, de Onis M. Rationale for developing a new international growth reference. Food Nutr Bull. 2004;25(Suppl1):S5–14.CrossRefPubMed Garza C, de Onis M. Rationale for developing a new international growth reference. Food Nutr Bull. 2004;25(Suppl1):S5–14.CrossRefPubMed
Metadata
Title
The prevalence, risk factors, and screening measure for prediabetes and diabetes among Emirati overweight/obese children and adolescents
Authors
Elham Al Amiri
Mona Abdullatif
Abdishakur Abdulle
Nibal Al Bitar
Elham Zaki Afandi
Monira Parish
Gassan Darwiche
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2649-6

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue