Obese children need to have their blood sugar tested regularly, say researchers.

Elevations in blood sugar, a sign of possible diabetes, may surface relatively rapidly, new research indicates. The findings were presented in San Diego at the Endocrine Society’s annual meeting.

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Obesity, Diabetes Soaring

The number of obese kids in the U.S. has never been higher. An estimated 16 percent of kids and teens aged 6-19 were overweight in 1999-2002, says the CDC. That’s 45 percent more than in 1988-1994.

Type 2 diabetes is ballooning along with obesity. About 150,000 people younger than 18 have diabetes; that’s around one in every 400 to 500, says the CDC.

There are two types of diabetes -- types 1 and 2. Children and young adults have typically have type 1 diabetes, in which the immune system destroys cells in the pancreas that make the hormone insulin, which controls blood sugar (glucose).

But more and more children are being diagnosed with type 2 diabetes, which has traditionally been seen in adults and is often associated with excess weight. Type 2 diabetes accounts for 8 percent to 43 percent of new childhood diabetes cases, says the CDC.

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The Tip of the Iceberg

Diabetes isn’t the only type of blood sugar problem. Children (or adults) who don’t have diabetes may have insulin resistance. That means they’re starting to have trouble controlling blood sugar and have to produce more and more insulin to get the job done. When blood sugars are higher than normal, yet not high enough to be diagnosed with diabetes, a termed prediabetes is used.

Insulin resistance and high blood sugar are also hallmarks of metabolic syndrome, a group of risk factors that also includes obesity (especially at the waist), high blood pressure, high blood levels of triglycerides (a type of fat), and low “good” HDL cholesterol. Researchers in Kansas recently reported shockingly high numbers of elementary school kids with or at risk for metabolic syndrome.

Metabolic syndrome sows the seeds for diabetes. From there, it’s a slippery slope toward heart disease risk. However, getting in shape, eating healthfully, and being active can help turn those troubles around.

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Problems Seen at Startlingly Young Ages

The latest findings come from Italy and the U.S.

Italian researchers studied nearly 200 children aged 5-17. They found that obese children had higher levels of insulin and resistance to insulin, putting them at a higher risk of developing diabetes. The study was conducted by experts including Sandro Loche, MD, of the Oespedale Regionale per le Microcitemie in Cagliari, Italy.

Another project centered on 44 obese 12-year-olds in Philadelphia. The Philadelphia research team included Janna Flint, MD, of Drexel University’s medical school and St. Christopher’s Hospital for Children.

The researchers found that during a 15-month follow-up period one in six children experienced changes in his or her metabolism of blood sugar. This shows that blood sugar metabolism can change over time and that regular blood sugar checks may be needed.

Initially four children had abnormalities in handling blood sugar. This indicated that they were at a higher risk of developing diabetes. During the follow-up period three of these children later went back to normal blood sugar levels. This was seen without significant changes in other factors often association with type 2 diabetes, such as weight or cholesterol levels.

The researchers also found that three children who initially tested normal later developed blood sugar abnormalities. This also occurred without any significant change in risk factors for developing diabetes such as weight and cholesterol.

They researchers say the findings indicate that long-term evaluation of blood sugar in obese children is needed regardless of changes in weight or other risks factors.

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By Miranda Hitti, reviewed by Brunilda Nazario, MD

SOURCES: The Endocrine Society’s 87th Annual Meeting, San Diego, June 4-7, 2005. CDC’s National Center for Health Statistics: “Prevalence of Overweight Among Children and Adolescents: United States, 1999-2002.” CDC Diabetes Public Health Resource: “Fact Sheet: SEARCH for Diabetes in Youth.” WebMD Medical News: “Metabolic Syndrome Found in Many Young Kids.” http://my.webmd.com/content/Article/106/108317.htm News releases, The Endocrine Society.