Pre-diabetes Prevalence and Associated Factors in New Zealand School Children: a Cross-sectional Study

Aims: The incidence of pre-diabetes and type 2 diabetes mellitus (T2DM) is increasing in children. Early identification of pre-diabetes is an important first step in preventing the progression to T2DM. The aim was to investigate the association of selected factors with pre-diabetes in children.

Methods: This data were from a subset of the 685 children recruited for the Children's Bone Study, a cross-sectional study of children aged 8-11 years in Auckland, New Zealand. Glycated haemoglobin (HbA1c) was measured from a finger-prick blood test. Children were classified as normoglycaemic (HbA1c≤39mmol/mol) and pre-diabetic (HbA1c>39mmol/mol). Anthropometry included weight, height, waist circumference (WC) and percentage body fat (%BF) measured using bioelectrical impedance analysis. Information about age, gender, ethnicity and physical activity was collected by questionnaires.

Results: HbA1c was measured in 451 children (10.4±0.6years, 45% male). Pre-diabetes was present in 71 (16%) children and was greatest in South Asian (n=13, 30%), Pacific Island (n=29, 27%) and Māori (n=10, 18%) children, compared with European children (n=10, 6.0%) (P< 0.001). South Asian and Pacific Island ethnicity, high WC, high %BF and low physical activity were associated with pre-diabetes.

Conclusions: Factors associated with pre-diabetes in children were ethnicity, anthropometric measures and physical-activity levels. The prevalence of pre-diabetes in children of South Asian and Pacific Island ethnicities suggests the need for appropriate and timely identification and intervention to halt the progression to T2DM.