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Front. Neurol. | doi: 10.3389/fneur.2019.00947

Diabetes type 2 in non-obese neurologically impaired children and adolescents: a new emerging entity?

 Valeria Calcaterra1*, Hellas Cena1,  Annalisanalisa De Silvestri2, Vincenza Girgenti3, Denisia Bommarito3 and Gloria Pelizzo3
  • 1University of Pavia, Italy
  • 2San Matteo Hospital Foundation (IRCCS), Italy
  • 3ARNAS Ospedali Civico Di Cristina Benfratelli, Italy

Background: Insulin resistance (IR) plays a key role in the pathogenesis of type 2 diabetes (T2D). In neurologically impaired (NI) children unfavorable cardio-metabolic risk profile with high prevalence of IR has been reported. We evaluated the prevalence of T2D in NI children and adolescents, in order to define if a dedicated glucose monitoring may be recommended in these subjects.
Methods: We retrospectively evaluated 63 patients (11.4±4.0 years) with severe disabilities. Auxological parameters were recorded. Metabolic blood assays included fasting blood glucose (FBG), fasting insulin, triglycerides (TG). IR was detected with the homeostasis model assessment for insulin resistance (HOMA-IR>97.5th percentile for age and sex) and triglyceride-glucose index (TyG index>7.88). Elevated FBG was defined with values >100 mg/dl. T2D was defined according to American Diabetes Association criteria.
Results: impaired insulin sensitivity, pathological TyG index and elevated FBG were observed respectively in 41.3%, 63.5% and 11.1% patients. T2D was diagnosed in 3.2% asymptomatic patients. The prevalence of diabetes was higher in prepubertal compared to pubertal subjects (p=0.03).
Conclusions: T2D in NI children and adolescents without obesity could represent a new emerging entity. IR and/or surrogate markers of IR index may be useful for the primary screening of this at-risk disabled population so as to prevent diabetes.

Keywords: type 2 diabetes, Disability, Children, adolescents, Neurologically impaired

Received: 17 May 2019; Accepted: 16 Aug 2019.

Copyright: © 2019 Calcaterra, Cena, De Silvestri, Girgenti, Bommarito and Pelizzo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. Valeria Calcaterra, University of Pavia, Pavia, Italy, valeria.calcaterra@unipv.it