Decreased -Cell Function in Overweight Latino Children With Impaired Fasting Glucose

Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
Diabetes Care (Impact Factor: 8.42). 11/2005; 28(10):2519-24. DOI: 10.2337/diacare.28.10.2519
Source: PubMed


To determine whether overweight Latino children with impaired fasting glucose (IFG) (> or = 100 mg/dl) have increased insulin resistance or decreased beta-cell function compared with those with normal fasting glucose (NFG).
We studied 207 healthy overweight Latino children, aged 8-13 years, with a family history of type 2 diabetes. Fasting and 2-h glucose and insulin were assessed by oral glucose tolerance test. Insulin sensitivity (S(i)), the acute insulin response to glucose (AIRg), and the disposition index (DI; an index of beta-cell function) were determined using the insulin-modified intravenous glucose tolerance test and minimal modeling. Body composition was determined by dual-energy X-ray absorptiometry.
There were no differences in body composition between NFG (n = 182) and IFG (n = 25) children. Compared with children with NFG, children with IFG had higher fasting and 2-h glucose values and higher fasting insulin. After adjusting for covariates, children with IFG had no difference in S(i) but 15% lower DI than NFG children (2,224 +/- 210 vs. 2,613 +/- 76, P < 0.05). Multivariate linear regression showed that AIRg and DI, but not S(i), were significant predictors of fasting blood glucose.
In overweight Latino adolescents with a family history of type 2 diabetes, IFG is associated with impaired beta-cell function and therefore may identify children likely to be at risk for progression to type 2 diabetes. The actual risk of progression of IFG to type 2 diabetes remains to be determined by prospective longitudinal studies.

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Available from: Geoff Ball, Sep 22, 2015
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    • "Saliva samples were processed immediately by centrifuging at 2500 rpm for 10 minutes and frozen at -70°C until assayed. Fasting blood was drawn to assess morning serum cortisol, followed by a 3-hour insulin-modified, frequently-sampled intravenous glucose tolerance test (FSIVGTT), as previously described [5]. "
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    ABSTRACT: There is an urgent need for innovative and developmentally appropriate lifestyle interventions to promote healthy lifestyle behaviors and to prevent the early onset of type 2 diabetes and cardiovascular disease risk in obese Latino adolescents. Guided imagery offers promise to reduce stress and promote lifestyle behavior change to reduce disease risk in obese adolescents. Our objectives were: 1) To pilot test a new 12-wk lifestyle intervention using a randomized trial design in obese Latino adolescents, in order to determine the effects of the mind-body modality of Interactive Guided ImagerySM (IGI), over and above those of a didactic lifestyle education, on insulin resistance, eating and physical activity behaviors, stress and stress biomarkers; and 2) To explore the role of intervention-related changes in stress and stress biomarkers on changes in metabolic outcomes, particularly insulin resistance. Obese (BMI > 95th percentile), Latino adolescents (n = 35, age 14-17) were randomized to receive either 12 weekly sessions of a lifestyle education plus guided imagery program (GI), or lifestyle education plus a digital storytelling computer program (DS). Between-group differences in behavioral, biological, and psychological outcomes were assessed using unpaired T-tests and ANCOVA in the 29 subjects who completed the intervention. The GI group demonstrated significant reductions in leisure sedentary behavior (p < .05) and increases in moderate physical activity (p < .05) compared to DS group, and a trend toward reduced caloric intake in GI vs DS (p = .09). Salivary cortisol was acutely reduced by stress-reduction guided imagery (p < .01). There were no group differences in adiposity, insulin resistance, perceived stress, or stress biomarkers across the 12-week intervention, though decrease in serum cortisol over the course of the intervention was associated with improved insulin sensitivity (p = .03) independent of intervention group and other relevant co-variates. The improvements in physical activity and stress biomarkers following this pilot intervention support the role of guided imagery in promoting healthy lifestyle behavior change and reducing metabolic disease risk in obese Latino adolescent populations. Future investigations will be needed to determine the full effects of the Imagine HEALTH intervention on insulin resistance, stress, and stress biomarkers.Trial registration: Registry #: NCT01895595.
    BMC Complementary and Alternative Medicine 01/2014; 14(1):28. DOI:10.1186/1472-6882-14-28 · 2.02 Impact Factor
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    • "Latino children are more likely to be insulin resistant than their Caucasian counterparts, independent of adiposity (4). Our group has shown that over 30% of overweight Latino children (aged 8 to 14 years) in the Los Angeles area have pre-diabetes (5,6) and the metabolic syndrome (7). While there are numerous pediatric interventions aimed at decreasing obesity (8,9), few randomized trials have targeted Latinos or addressed the underlying metabolic abnormalities, specifically visceral fat, insulin secretion and resistance. "
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    International journal of pediatric obesity: IJPO: an official journal of the International Association for the Study of Obesity 04/2010; 5(5):451-5. DOI:10.3109/17477161003770123 · 3.03 Impact Factor
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