The effect of impaired glucose metabolism on weight loss in multidisciplinary childhood obesity treatment

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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, Holbaek, 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-β-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 < .0001, P = .0005). During treatment, values of glucose, HbA1c, HOMA2-IS, and HOMA2-B did not change or impact the treatment outcome, regardless of age, sex, SES, or degree of obesity at treatment entry.

CONCLUSION: The capability to reduce weight during multidisciplinary treatment in children and adolescents with overweight/obesity is not influenced by an impaired glucose metabolism at study entry or during the course of treatment.

Original languageEnglish
JournalPediatric Diabetes
Issue number3
Pages (from-to)366-374
Number of pages9
Publication statusPublished - 2018

Bibliographical note

Funding information The Novo Nordisk Foundation, Grant/Award number: NNF15OC0016544; Novo Nordisk, Grant/Award number: unrestricted educational grant; The Danish Innovation Foundation, Grant/Award number: 0603‐00457B; The Region Zealand Health Scientifics Research Foundation

    Research areas

  • Journal Article, Body Mass Index, Glucose Intolerance/blood, Humans, Insulin/blood, Blood Glucose, Male, Prediabetic State/blood, Pediatric Obesity/blood, Young Adult, Weight Loss, Adolescent, Female, Glycated Hemoglobin A/metabolism, C-Peptide/blood, Weight Reduction Programs/statistics & numerical data, Child, Longitudinal Studies, prediabetes, weight loss, children, impaired glucose metabolism, obesity

ID: 189863928