Obesity is one ofthe biggest first world health problems.

Being obese increases the risk formany diseases, Diabetes Mellitus Type II (T2DM) is oneof the major health problems from that lengthy list of diseases. Overweightchildren have as high a likelihood to be obese as an adult. At home behavioraltreatment to control weight gain has shown promising results to improve healthoutcomes. Metabolic syndrome, hyperlipidemia, sleep apnea, and fatty liverdisease are few of many other comorbidities common in obese children andadolescent. Obesity and T2D are worrisome healthcare issues and need to beresearched aggressively to prevent rising health problems. Not only does obesityupsurge the healthcare cost but it also decreases the quality of life.

 It also causes the decline of lifeexpectancy.  Prevention has always provenbetter than treatment which will in the future help us save on healthcare costs.Obesity is more predominant in the recent age group as compared to the previousage group making it a noteworthy health matter.   Body Mass Index and Incident Type 1 and Type 2Diabetes in Children and Young Adults: A Retrospective Cohort Study, a researchstudy done in the UK based in part on data from the Clinical Practice ResearchDatalink obtained under license from the UK Medicines and Healthcare ProductsRegulatory Agency, addresses the issues above.

The study was published in the Journalof Endocrine society, Volume 1, Issue 5, 1 May 2017, Pages 524-537. The objectiveof the study was to examine the recent incidence of Type 1 and Type 2 diabetesin relation to high body mass index in UK children and young adults. It wasbased on cohort and case control design of study. The study was based on theBMI measurements of a total of 369,362 participants from the age group 2 to 15years old from 1994 to 2013. No intervention was used during the study.

Thestudy used the Cohort method of analysis, the data was collected using aprimary care database of electronic health records from the UK called ClinicalPractice Research Datalink. Individuals for the study were sampled from the 375English General Practices, the age groups of the individuals were between 2 to15 and the BMI values were recorded between 1994 and 2013. In the study Type 1and Type 2 Diabetes were determined according to the medical diagnostic codes,prescriptions, or hemoglobin A1c value.

The patients were considered to havetype 1 diabetes if they had a diagnosis of type 1 diabetes or had beenprescribed insulin and had never been prescribed oral glucose-loweringmedications in the CPRD. Type 2 diabetes was defined as a diagnosis of type 2diabetes, the prescription of oral glucose-lowering medications only, or adiagnosis of diabetes mellitus or HbA1c ?6.5% (48 mmol/mol) but no insulinprescription. (Abbasi, 2017). To determine obesity the study converted the BMIvalues to Z-Scores.

Normal weight was defined as BMI Z-Score < 1.04.Overweight was BMI Z-Score 1.04 to1.64 and obese as BMI Z-Score higher thanthat.  A total of 654cases of type 2 diabetes and 1,318 cases of type 1 diabetes were found in thestudy. The study showed that obese individuals were at four times the risk ofincident type 2 diabetes as those with a normal BMI.

The study observed noassociation between obesity and type 1 diabetes.  The study involveshuman subjects which meets the definition of regulated research. The level of IRBreview necessary would be expedited review because the study used the datacollected from the electronic medical records. The study did not use anyinvasive measurements, nor did it pose any risks to the subjects of study.

Thestudy was a prospective study as it involved taking cohort of subjects andobserving them over an extended period of time for the outcome which was T2Dand T1D and relating it to the risk factors such as obesity.  The conclusion ofthe study matches my hypothesis that obesity is the major cause of Type 2Diabetes in children.      Abbasi, A.

,Juszczyk, D., Jaarsveld, C. H., & Gulliford, M. C. (2017). Body Mass Indexand Incident Type 1 and Type 2 Diabetes in Children and Young Adults: ARetrospective Cohort Study. Journal of the Endocrine Society, 1(5),524-537.



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