A systematic review and meta-analysis of 53 studies incorporating nearly 9000 participants suggests 75% of children with type 2 diabetes also had obesity, with more than 75% of this group having a diagnosis of obesity at time of diagnosis for type 2 diabetes. Results of the study also shed light into potential risk factors for obesity in this cohort, including male sex and race.
“In this study, while obesity was an important risk factor for the development of [type 2 diabetes] in children, not all patients with [type 2 diabetes] had obesity. Screening for and diagnosing [type 2 diabetes] may consider obesity as a risk factor for [type 2 diabetes] but not a prerequisite to screening when other risk factors are present,” wrote investigators.
Few public health issues carry the same societal level burden as those of type 2 diabetes and obesity. Citing the belief that childhood obesity epidemic is driving increases in rates of pediatric type 2 diabetes, a team of investigators from McMaster University along with other collaborators from international institutions sought to investigate trends in prevalence of obesity in pediatric type 2 diabetes through a systematic review and meta-analysis of published works within the MEDLINE, Embase, CINAHL, Cochrane Library, and Web of Science databases database inception to June 16, 2022.
For the purpose of analysis, investigators only included observational studies with at least 10 participants reporting prevalence of obesity in pediatric type 2 diabetes. The primary outcome of interest for the analysis was the pooled prevalence of obesity in type 2 diabetes. The analysis’s multiple secondary outcomes of interest included pooled prevalence rates by sex and race and associations between obesity and glycemic control and dyslipidemia.
In total, investigators identified 57 articles for inclusion in the systematic review and 53 articles, with a population of 8942 participants, for inclusion in the meta-analysis. Of the 57 studies identified by investigators, 26 had a cross-sectional design, 23 were retrospective cohort studies, and 6 were prospective cohort studies. Of note, 12 of the 57 studies did not report specific diabetes diagnostic criteria.
Results of the investigators’ analysis suggested the overall prevalence of obesity among those with pediatric type 2 diabetes was 75.27% (95% CI, 70.47-79.78). Further analysis indicated the prevalence of obesity at diabetes diagnosis among 4688 participants was 77.24% (95% CI, 70.55-83.34). When assessing factors associated with increased odds of obesity, results indicated male participants had higher odds of obesity than their female counterparts (OR, 2.10 [95% CI, 1.33-3.31]). When evaluating the influence of race or ethnicity, results suggested Asian participants had the lowest prevalence of obesity (64.50% [95% CI, 53.28-74.99]), and White participants had the highest prevalence of obesity (89.86% [95% CI, 71.50-99.74]) among racial groups. Investigators noted high heterogeneity was observed across studies as well as varying degrees of glycemic control and dyslipidemia.
“Understanding the causes of T2D in children without obesity is crucial to define the etiology of their diabetes and to create effective management strategies for this cohort,” concluded investigators. “Further research is needed to evaluate the causes of sex- and race and ethnicity–based associations of diabetes with obesity and explore additional factors that may affect the risk of developing T2D apart from obesity in children.”
This study, “The Prevalence of Obesity Among Children With Type 2 Diabetes,” was published in JAMA Network Open.