Severe Obesity in High-Risk Youth Correlates Directly to Increased Incidence of Type 2 Diabetes


Michelle Kirkwood

San Diego, California
June 9, 2017

The risk of developing type 2 diabetes (T2D) by age 20 was 12 times as high in severely obese American Indian children 5 to 9 years of age as in normal-weight youth in that age range, according to a study titled “Long-term Risk of Type 2 Diabetes in Youth with Increasing Severity of Obesity,” presented today at the American Diabetes Association’s 77th Scientific Sessions® at the San Diego Convention Center. 

Obesity is a serious health problem among youth, especially in populations at high risk of developing T2D. Previous studies of obesity in youth have reported a strong relationship between body mass index (BMI) and subsequent incidence of T2D in adults and adolescents. However, prior studies have not assessed the long-term risk in youths with extremely high BMIs, i.e., the severe degrees of obesity often seen today.

This longitudinal study examined the risk of diabetes and other metabolic abnormalities in obese and severely obese American Indian youths from the southwestern U.S., a population with a high risk of developing T2D. The incidence of T2D was computed in 2,728 children without diabetes aged 5-9 years, and a partially overlapping group of 4,317 youths aged 10-17 years. They were followed up to age 45 or until the onset of T2D. Age-sex specific BMI percentiles were defined by the 2000 U.S. Centers for Disease Control and Prevention (CDC) growth charts. The CDC defines obesity as being at or above a cut-point specified as the 95th BMI percentile. 

T2D incidence rates increased in direct proportion with severity of obesity. Compared with 5-9-year old nonobese children with BMIs in the middle of the BMI distribution, children of the same age with BMIs at least 40 percent above the cut-point defining obesity had 12 times the incidence rates of T2D by age 20 years and 3 times the incidence rates of T2D by age 45 years. BMI had similar effects on T2D incidence in those 10-17 years old at baseline.

“We had previously found BMI in youth to be a strong predictor of type 2 diabetes, but we had not examined diabetes incidence rates in those with the severe degree of obesity that is prevalent today. We did not know if diabetes incidence rates among the obese plateaued among those with extremely high BMI,” said study author Madhumita Sinha, MD, MHSM, staff clinician at the Diabetes Epidemiology and Clinical Research Section of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health (NIH) in Phoenix, Ariz. “This study clearly shows that the risk of developing type 2 diabetes is associated with BMI, especially at very high extremes.”

“Parents and health care providers should be aware of the future diabetes risk associated with obesity in youth, especially as more severe degrees of obesity become more prevalent,” explained Sinha. “Results of our analysis emphasize the importance of developing effective means of preventing or treating obesity in youth, and additional risk factors for type 2 diabetes in youth should be explored for their interactions with severe obesity.” 

To speak with Dr. Sinha, please contact the Association’s media relations team on-site at the San Diego Convention Center on June 9 -13, by phone at 619-525-6250 or by email at Dr. Sinha can also be reached via the NIDDK communications office at or 301-496-3583.

The American Diabetes Association’s 77th Scientific Sessions, to be held June 9-13, 2017, at the San Diego Convention Center, is the world’s largest scientific meeting focused on diabetes research, prevention and care. During the five-day meeting, health care professionals have exclusive access to more than 2,500 original research presentations, participate in provocative and engaging exchanges with leading diabetes experts, and can earn Continuing Medical Education (CME) or Continuing Education (CE) credits for educational sessions. The program is grouped into eight interest areas: Acute and Chronic Complications; Behavioral Medicine, Clinical Nutrition, Education and Exercise; Clinical Diabetes/Therapeutics; Epidemiology/Genetics; Immunology/Transplantation; Insulin Action/Molecular Metabolism; Integrated Physiology/Obesity; and Islet Biology/Insulin Secretion. Brenda Montgomery, RN, MSHS, CDE¹, President of Health Care and Education , will deliver her address on Saturday, June 10, and Alvin C. Powers, MD, President of Medicine and Science, will present his address on Sunday, June 11. Eight abstracts were selected by the Scientific Sessions Meeting Planning Committee to be presented on Tuesday, June 13, in the President’s Oral Session. These abstracts represent important research being conducted in the field of diabetes today. In total, the 2017 Scientific Sessions includes 378 abstracts in 49 oral sessions; 2,152 poster presentations including 50 moderated poster discussions; and 360 published-only abstracts.

About the American Diabetes Association

Nearly half of American adults have diabetes or prediabetes; more than 30 million adults and children have diabetes; and every 21 seconds, another individual is diagnosed with diabetes in the U.S. Founded in 1940, the American Diabetes Association (ADA) is the nation’s leading voluntary health organization whose mission is to prevent and cure diabetes, and to improve the lives of all people affected by diabetes. The ADA drives discovery by funding research to treat, manage and prevent all types of diabetes, as well as to search for cures; raises voice to the urgency of the diabetes epidemic; and works to safeguard policies and programs that protect people with diabetes. In addition, the ADA supports people living with diabetes, those at risk of developing diabetes, and the health care professionals who serve them through information and programs that can improve health outcomes and quality of life. For more information, please call the ADA at 1-800-DIABETES (1-800-342-2383) or visit Information from both of these sources is available in English and Spanish. Find us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn)

1 Disclosures for Brenda Montgomery. Employer: AstraZeneca Pharmaceuticals. Montgomery's role as President, Health Care & Education of the American Diabetes Association (Association) is a voluntary position to which she was elected by the members of the Association in 2015. She continues to recuse herself from any and all discussions, decisions or votes that have or could be perceived as having a conflict of interest with her employer.