Iycee Charles de Gaulle Summary Obesity primary care database of electronic health

Obesity primary care database of electronic health

Obesity is one of
the biggest first world health problems. Being obese increases the risk for
many diseases, Diabetes Mellitus Type II (T2DM) is one
of the major health problems from that lengthy list of diseases. Overweight
children have as high a likelihood to be obese as an adult. At home behavioral
treatment to control weight gain has shown promising results to improve health
outcomes. Metabolic syndrome, hyperlipidemia, sleep apnea, and fatty liver
disease are few of many other comorbidities common in obese children and
adolescent. Obesity and T2D are worrisome healthcare issues and need to be
researched aggressively to prevent rising health problems. Not only does obesity
upsurge the healthcare cost but it also decreases the quality of life.  It also causes the decline of life
expectancy.  Prevention has always proven
better than treatment which will in the future help us save on healthcare costs.
Obesity is more predominant in the recent age group as compared to the previous
age group making it a noteworthy health matter.


 Body Mass Index and Incident Type 1 and Type 2
Diabetes in Children and Young Adults: A Retrospective Cohort Study, a research
study done in the UK based in part on data from the Clinical Practice Research
Datalink obtained under license from the UK Medicines and Healthcare Products
Regulatory Agency, addresses the issues above. The study was published in the Journal
of Endocrine society, Volume 1, Issue 5, 1 May 2017, Pages 524-537. The objective
of the study was to examine the recent incidence of Type 1 and Type 2 diabetes
in relation to high body mass index in UK children and young adults. It was
based on cohort and case control design of study. The study was based on the
BMI measurements of a total of 369,362 participants from the age group 2 to 15
years old from 1994 to 2013. No intervention was used during the study. The
study used the Cohort method of analysis, the data was collected using a
primary care database of electronic health records from the UK called Clinical
Practice Research Datalink. Individuals for the study were sampled from the 375
English General Practices, the age groups of the individuals were between 2 to
15 and the BMI values were recorded between 1994 and 2013. In the study Type 1
and Type 2 Diabetes were determined according to the medical diagnostic codes,
prescriptions, or hemoglobin A1c value. The patients were considered to have
type 1 diabetes if they had a diagnosis of type 1 diabetes or had been
prescribed insulin and had never been prescribed oral glucose-lowering
medications in the CPRD. Type 2 diabetes was defined as a diagnosis of type 2
diabetes, the prescription of oral glucose-lowering medications only, or a
diagnosis of diabetes mellitus or HbA1c ?6.5% (48 mmol/mol) but no insulin
prescription. (Abbasi, 2017). To determine obesity the study converted the BMI
values to Z-Scores. Normal weight was defined as BMI Z-Score < 1.04. Overweight was BMI Z-Score 1.04 to1.64 and obese as BMI Z-Score higher than that.   A total of 654 cases of type 2 diabetes and 1,318 cases of type 1 diabetes were found in the study. The study showed that obese individuals were at four times the risk of incident type 2 diabetes as those with a normal BMI. The study observed no association between obesity and type 1 diabetes.   The study involves human subjects which meets the definition of regulated research. The level of IRB review necessary would be expedited review because the study used the data collected from the electronic medical records. The study did not use any invasive measurements, nor did it pose any risks to the subjects of study. The study was a prospective study as it involved taking cohort of subjects and observing them over an extended period of time for the outcome which was T2D and T1D and relating it to the risk factors such as obesity.   The conclusion of the study matches my hypothesis that obesity is the major cause of Type 2 Diabetes in children.           Abbasi, A., Juszczyk, D., Jaarsveld, C. H., & Gulliford, M. C. (2017). Body Mass Index and Incident Type 1 and Type 2 Diabetes in Children and Young Adults: A Retrospective Cohort Study. Journal of the Endocrine Society, 1(5), 524-537. doi:10.1210/js.2017-00044          

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