Screening children of type 2 diabetes mellitus parents

Rajarajan, A C (2018) Screening children of type 2 diabetes mellitus parents. Masters thesis, Kilpauk Medical College, Chennai.

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Abstract

Introduction: Diabetes mellitus is a group of disorders having varying aetiology and pathogenesis. It is characterized by hyperglycemia and glycosuria.Type 2 diabetes mellitus in children and adolescents is emerging as a new clinical problem within pediatric practice. Recent reports indicate an increasing prevalence of type 2 diabetes mellitus in children and adolescents around the world in all ethnicities. Screening for diabetes is needed for at-risk asymptomatic children to prevent Type 2 diabetes related morbidity and mortality. Screening should commence at the age of 10 years and should be repeated every 2 years. HbA1c and FPG are equally effective screening tools for the detection of Type 2 diabetes. Aims and Objectives: The aim of the study is to screen the children of Type 2 Diabetic mellitus Parents using Hba1c test for early detection of diabetes to prevent long term consequences and metabolic syndromes. Materials and methods: It is a Cross sectional hospital based study done at Govt. Royapettah Hospital, Chennai. A total of 140 children aged between 10-19 years who were brought by the Type 2 DM parents were enrolled in our study. Mean age of the study population was 14.5 years. Majority of the children belonged to 16-19 years (45.71%) i.e. adolescent age. Among the study population, the proportions of boys were 86 in number (61.43%) and girls were 54 in number (38.57%). Anthropometric measurements like Height, weight and BMI & signs of insulin resistance like acanthosis nigricans, PCOD in female child [by USG], and Blood pressure has been recorded for all those children. Venous blood sample was been collected under aseptic sterile technique in fasting state and sent for HbA1c test using HPLC method. HbA1c cut off criteria used in our study was HbA1c < 5.6 as normal level, HbA1c > 5.7 to 6 as prediabetic and HbA1c > 6 classified as diabetic. Results: 18 children belonged to the BMI category of overweight (12.86%). All the children had normal BP. 27 children (19.29%) were noted to have acanthosis nigricans. Among the 54 female children 2 girls (3.70%) had PCOD on ultrasound examination. In our study the mean HbA1c level was 4.9± 0.31 which correlated with Jinan B saddine et al study. Variations of HbA1C level with specific age and sex group was analysed statistically but the differences in HbA1c level and specific age and sex group was not statistically significant. Among the 140 children and adolescent screened for diabetes 4 children 3.4% (1boy and 3 girls) were found to have high HbA1c level >5.6 were diagnosed to have prediabetes. In our study the overall prevalence of pre-diabetes in children and adolescents aged 10- 16years was 2.86% and the prevalence of pre-diabetes among the girls with high risk factors was 5.56% and in boys was 1.16%. The prevalence of prediabetes in overweight children was 25%. Acanthosis nigricans was present in 11.1% of children with prediabetes. Conclusion: Identification of type 2 diabetes in the asymptomatic children in the prediabetic stage itself by HBA1C analysis must be encouraged in the pediatric practice. By early screening for diabetes in children of T2DM parents we can prevent Type 2 diabetes related morbidity and mortality. In our study we included 140 subjects as sample size which was small to make comparisons and to draw conclusions for the general population. Hence large scale studies are needed to know the accurate prevalence of diabetes in children and adolescents among general population.

Item Type: Thesis (Masters)
Uncontrolled Keywords: T2DM (Type 2 diabetes mellitus): Prediabetes: BMI (Body mass index) HbA1c (glycated hemoglobin): HPLC (High performance liquid chromatography)
Subjects: MEDICAL > Paediatrics
Depositing User: Subramani R
Date Deposited: 13 Aug 2018 16:47
Last Modified: 13 Aug 2018 16:47
URI: http://repository-tnmgrmu.ac.in/id/eprint/9243

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