TY - JOUR
T1 - Insulin resistance in children
T2 - Consensus, perspective, and future directions
AU - Levy-Marchal, Claire
AU - Arslanian, Silva
AU - Cutfield, Wayne
AU - Sinaiko, Alan
AU - Druet, Celine
AU - Marcovecchio, M. Loredana
AU - Chiarelli, Francesco
AU - Amemiyia, Shin
AU - Berenson, Gerald
AU - Caprio, Sonia
AU - Charles, Marie Aline
AU - Cook, Stephen
AU - Davis, Elizabeth
AU - Dolan, Larry
AU - Dunger, David
AU - Fagot-Campagna, Anne
AU - Flodmark, Carl Erik
AU - Ford, Earl
AU - Gautier, Jean François
AU - Goodman, Elizabeth
AU - Goran, Michael
AU - Haymond, Morey
AU - Hofman, Paul
AU - Hokken-Koelega, Anita
AU - Ibanez, Lourdes
AU - Lee, So Jung
AU - Maffeis, Claudio
AU - Mericq, Veronica
AU - Metzger, Boyd
AU - Norgren, Svante
AU - Ong, Ken
AU - Pettitt, David
AU - Rudolf, Mary
AU - Schwimmer, Jeffrey
AU - Steinberger, Julia
AU - Weiss, Ram
AU - Yajnik, Chittaranjan
N1 - Funding Information:
The conference was partly supported by educational grants from Institut National de la Santé et de la Recherche Médicale (France) and Ipsen (France).
PY - 2010/12
Y1 - 2010/12
N2 - Objective: Emerging data indicate that insulin resistance is common among children and adolescents and is related to cardiometabolic risk, therefore requiring consideration early in life. However, there is still confusion on how to define insulin resistance, how to measure it, what its risk factors are, and whether there are effective strategies to prevent and treat it. A consensus conference was organized in order to clarify these points. Participants: The consensus was internationally supported by all the major scientific societies in pediatric endocrinology and 37 participants. Evidence: An independent and systematic search of the literature was conducted to identify key articles relating to insulin resistance in children. Consensus Process: The conference was divided into five themes and working groups: background and definition; methods of measurement and screening; risk factors and consequences; prevention; and treatment. Each group selected key issues, searched the literature, and developed a draft document. During a 3-d meeting, these papers were debated and finalized by each group before presenting them to the full forum for further discussion and agreement. Conclusions: Given the current childhood obesity epidemic, insulin resistance in children is an important issue confronting health care professionals. There are no clear criteria to define insulin resistance in children, and surrogate markers such as fasting insulin are poor measures of insulin sensitivity. Based on current screening criteria and methodology, there is no justification for screening children for insulin resistance. Lifestyle interventions including diet and exercise can improve insulin sensitivity, whereas drugs should be implemented only in selected cases.
AB - Objective: Emerging data indicate that insulin resistance is common among children and adolescents and is related to cardiometabolic risk, therefore requiring consideration early in life. However, there is still confusion on how to define insulin resistance, how to measure it, what its risk factors are, and whether there are effective strategies to prevent and treat it. A consensus conference was organized in order to clarify these points. Participants: The consensus was internationally supported by all the major scientific societies in pediatric endocrinology and 37 participants. Evidence: An independent and systematic search of the literature was conducted to identify key articles relating to insulin resistance in children. Consensus Process: The conference was divided into five themes and working groups: background and definition; methods of measurement and screening; risk factors and consequences; prevention; and treatment. Each group selected key issues, searched the literature, and developed a draft document. During a 3-d meeting, these papers were debated and finalized by each group before presenting them to the full forum for further discussion and agreement. Conclusions: Given the current childhood obesity epidemic, insulin resistance in children is an important issue confronting health care professionals. There are no clear criteria to define insulin resistance in children, and surrogate markers such as fasting insulin are poor measures of insulin sensitivity. Based on current screening criteria and methodology, there is no justification for screening children for insulin resistance. Lifestyle interventions including diet and exercise can improve insulin sensitivity, whereas drugs should be implemented only in selected cases.
UR - http://www.scopus.com/inward/record.url?scp=78650053173&partnerID=8YFLogxK
U2 - 10.1210/jc.2010-1047
DO - 10.1210/jc.2010-1047
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AN - SCOPUS:78650053173
SN - 0021-972X
VL - 95
SP - 5189
EP - 5198
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 12
ER -
