A Scoping Review of the Role of Childhood Obesity in Early-Onset Type 2 Diabetes Mellitus

Childhood obesity poses a significant public health concern globally and is exacerbated by its association with the early onset of type 2 diabetes mellitus. Observations suggest that approximately half of children worldwide were predicted to be impacted by childhood obesity by 2020, a concerning statistic, particularly in areas where obesity has surpassed underweight as the leading health concern.

According to the Centers for Disease Control and Prevention, the factors associated with excessive weight gain in children are similar to those found in adults. These factors include genetic predisposition, environmental influences, dietary patterns, cultural factors, metabolic processes, individual behaviors, and family history. Moreover, there is a rising prevalence of associated comorbidities such as type 2 diabetes mellitus, hypertension, asthma, dental issues, and liver disorders with childhood obesity. This observation is corroborated by a study that showed obese children are four times more likely to develop type 2 diabetes mellitus compared to those with normal weight. The increase in cases of early-onset type 2 diabetes is attributed to several factors, including family history, gender, sedentary lifestyle, poor dietary habits, and insulin resistance in adipose tissue.

Growing research indicates that early-onset type 2 diabetes mellitus is more aggressive than later-onset type 2 diabetes mellitus, characterized by rapid onset and development of complications affecting both large and small blood vessels. Globally, 371 million people, including children, are predicted to have early-onset type 2 diabetes mellitus; by 2023, that number is expected to rise to 552 million. Hence, the current scoping review was conducted to explore the role of childhood obesity in the development of early-onset diabetes mellitus.

A standardized approach for reviews was used to examine pertinent English-language literature published between 2000 and 2021. The investigation of the relationship between childhood obesity and early-onset type 2 diabetes mellitus was limited to primary research, systematic reviews, and meta-analyses. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format was followed during the review, and only 17 of the 3614 papers were eventually included in this scoping review.

The majority of the data on childhood obesity and early-onset diabetes mellitus is derived from high-income nations, mostly from North America and Asia, while African and Australian studies are rather scarce. This discrepancy draws attention to a research gap regarding the relationship between childhood obesity and early-onset diabetes mellitus, particularly in low- and middle-income nations, and emphasizes the need for more thorough worldwide delineation.

The results of these investigations have identified numerous risk factors responsible for the development of type 2 diabetes mellitus. The majority of research linked poor lipid profiles and hypertension to the development of obesity. However, it is crucial to recognize that these results are based on the currently available literature and might not include all of the studies conducted on early-onset type 2 diabetes mellitus and childhood obesity. Moreover, in the absence of studies that can show data with geographical variations, it will be disparaging to apply these findings or results in other regions. This, in turn, necessitates the need to include studies with a variety of populations to have a deeper understanding of the association between childhood obesity and early-onset type 2 diabetes mellitus. Among the factors responsible for the transition of childhood obesity into type 2 diabetes mellitus, insulin resistance in the adipose tissue of obese individuals is considered crucial. Evidence has shown that in obese children, this transition occurs rapidly, within about half the time it takes to occur in obese adults, who usually take ten years or more.

Additionally, the review has demonstrated the critical role of obesity in the progressive development of insulin resistance, subsequently causing type 2 diabetes mellitus, even in individuals with type 1 diabetes. However, further study is required, with an emphasis on larger population samples along with experimental, retrospective, and prospective investigations, to address the challenges in differentiating between diabetes types.

Source: Oranika US, Adeola OL, Egbuchua TO, Okobi OE, Alrowaili DG, Kajero A, Koleowo OM, Okobi E, David AB, Ezeamii JC. The Role of Childhood Obesity in Early-Onset Type 2 Diabetes Mellitus: A Scoping Review. Cureus. 2023 Oct 31;15(10):e48037. doi: 10.7759/cureus.48037. PMID: 38034219; PMCID: PMC10687489.