ARS | Publication request: Presence of Diabetes Risk Factors in a Large U.S. Eighth-Grade Cohort

Submitted to: Diabetes Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: October 23, 2005
Publication Date: February 1, 2006
Citation: Baranowski, T., Cooper, D.M., Harrell, J., Hirst, K., Linder, B., Kaufman, F.R., Goran, M., Resnicow, K. The STOPP-T2D Prevention Study Group. 2006. Presence of diabetes risk factors in a large U.S. eight-grade cohort. Diabetes Care. 29(2):212-217.

Interpretive Summary: This is the first large study (n=1740) of the prevalence of diabetes and its risks among mostly ethnic minority middle school students at three sites across the U.S. Forty-nine percent had BMI above the 85th percentile. The prevalence of diabetes (as determined from an oral glucose tolerance test) was less than 1%. However, 41% had an elevated fasting glucose and 36% had an elevated fasting insulin, and the likelihood of elevated risks increased with levels of BMI. Thus, while the prevalence of frank diabetes was lower than expected, the risk was higher, suggesting an increased incidence of diabetes in the coming years.

Technical Abstract: OBJECTIVE: The study was conducted in 12 middle schools to determine the prevalence of diabetes, pre-diabetes, and diabetes risk factors in eighth-grade students who were predominantly minority and to evaluate the feasibility of collecting physical and laboratory data in schools. RESEARCH DESIGN AND METHODS: Anthropometric measurements and fasting and 2-h post-glucose load blood draws were obtained from approximately 1,740 eighth-grade students. RESULTS: Mean recruitment rate was 50% per school, 49% had BMI > or = 85th percentile, 40.5% had fasting glucose > or = 100 mg/dl, 0.4% had fasting glucose > or = 126 mg/dl, and 2.0% had 2-h glucose > or = 140 mg/dl and 0.1% > or = 200 mg/dl. Mean fasting insulin value was 30.1 microU/ml, 36.2% had fasting insulin > or = 30 microU/ml, and 2-h mean insulin was 102.1 microU/ml. Fasting and 2-h glucose and insulin values increased across BMI percentiles, and fasting glucose was highest in Hispanic and Native American students. CONCLUSIONS: There was a high prevalence of risk factors for diabetes, including impaired fasting glucose (> or =100 mg/dl), hyperinsulinism suggestive of insulin resistance (fasting insulin > or = 30 microU/ml), and BMI > or = 85th percentile. These data suggest that middle schools are appropriate targets for population-based efforts to decrease overweight and diabetes risk.