The Prevalence of Obesity Among Children With Type 2 Diabetes : A Systematic Review and Meta-analysis

Key Points

Question

What is the prevalence of obesity in pediatric patients with type 2 diabetes (T2D)?

Findings

This systematic review and meta-analysis of 53 studies including 8942 participants found that 75.27% of children with T2D had obesity, and 77.24% had obesity at diagnosis. Male participants had significantly higher odds of obesity than female participants, and Asian participants had the lowest prevalence of obesity compared with other racial groups.

Meaning

In this study, not all pediatric patients with T2D had obesity; further studies are needed to elucidate the mechanisms beyond obesity driving this condition in children.

Abstract

This systematic review and meta-analysis evaluates the global prevalence of obesity in pediatric type 2 diabetes, examines the association of sex and race with obesity risk, and assesses the association of obesity with glycemic control and dyslipidemia.

Abstract

Importance

The childhood obesity epidemic is presumed to drive pediatric type 2 diabetes (T2D); however, the global scale of obesity in children with T2D is unknown.

Objectives

To evaluate the global prevalence of obesity in pediatric T2D, examine the association of sex and race with obesity risk, and assess the association of obesity with glycemic control and dyslipidemia.

Data Sources

MEDLINE, Embase, CINAHL, Cochrane Library, and Web of Science were searched from database inception to June 16, 2022.

Study Selection

Observational studies with at least 10 participants reporting the prevalence of obesity in patients with pediatric T2D were included.

Data Extraction and Synthesis

Following the Meta-analysis of Observational Studies in Epidemiology reporting guideline, 2 independent reviewers in teams performed data extraction and risk of bias and level of evidence analyses. The meta-analysis was conducted using a random-effects model.

Main Outcomes and Measures

The primary outcomes included the pooled prevalence rates of obesity in children with T2D. The secondary outcomes assessed pooled prevalence rates by sex and race and associations between obesity and glycemic control and dyslipidemia.

Results

Of 57 articles included in the systematic review, 53 articles, with 8942 participants, were included in the meta-analysis. The overall prevalence of obesity among pediatric patients with T2D was 75.27% (95% CI, 70.47%-79.78%), and the prevalence of obesity at diabetes diagnosis among 4688 participants was 77.24% (95% CI, 70.55%-83.34%). While male participants had higher odds of obesity than female participants (odds ratio, 2.10; 95% CI, 1.33-3.31), Asian participants had the lowest prevalence of obesity (64.50%; 95% CI, 53.28%-74.99%), and White participants had the highest prevalence of obesity (89.86%; 95% CI, 71.50%-99.74%) compared with other racial groups. High heterogeneity across studies and varying degrees of glycemic control and dyslipidemia were noted.

Conclusions and Relevance

The findings of this systematic review and meta-analysis suggest that obesity is not a universal phenotype in children with T2D. Further studies are needed to consider the role of obesity and other mechanisms in diabetes genesis in this population.