Association between Prediabetes Diagnosis and Body Mass Index Trajectory of Overweight and Obese Adolescents.

TitleAssociation between Prediabetes Diagnosis and Body Mass Index Trajectory of Overweight and Obese Adolescents.
Publication TypeJournal Article
Year of Publication2020
AuthorsVajravelu MEllen, Lee JM, Shah R, Shults J, Amaral S, Kelly A
JournalPediatr Diabetes
Date Published2020 Apr 21

BACKGROUND: Prediabetes awareness in adults has been associated with improved weight management. Whether youth with prediabetes diagnosis experience similar improvements is unknown.

OBJECTIVE: To investigate the association between prediabetes identification and body mass index trajectory in overweight and obese adolescents.

SUBJECTS: Youth who were followed longitudinally in a large academic-affiliated primary care network and who were overweight/obese while 10-18 years old.

METHODS: Retrospective cohort study. Subjects were categorized as "screened" if at least 1 hemoglobin A1c (HbA1c) result was available. Time series analysis was used to determine the difference in difference (DID) in body mass index Z-score (BMI-Z) slope before and after HbA1c between: 1) screened youth found to have prediabetes-range HbA1c (5.7-6.4%, 39-46 mmol/mol) versus normal HbA1c, and 2) screened versus age-matched unscreened obese youth.

RESULTS: 4,184 (55.6% female) screened subjects (median follow-up 9.7 years) were included. 637 (15.2%) had prediabetes-range HbA1c. Prediabetes was associated with a greater decrease in BMI-Z slope than normal HbA1c (DID: -0.023/year [95% CI: -0.042 to -0.004]). When compared to age-matched unscreened subjects (n=2,087), screened subjects (n=2,815) experienced a greater decrease in BMI-Z slope after HbA1c than unscreened subjects at a matched age (DID: -0.031/y [95% CI -0.042 to -0.021]).

CONCLUSIONS: BMI-Z trajectory improved more among youth with prediabetes-range HbA1c but also stabilized in screened youth overall. Prospective studies are needed to identify provider- and patient-level drivers of this observation. This article is protected by copyright. All rights reserved.

Alternate JournalPediatr Diabetes
PubMed ID32314478