To the Editor.—

We read with great interest the Pediatrics article by Reinehr et al. The authors provided important information about the changes in insulin sensitivity in obese children and adolescents according to degree of weight loss, showing that a decrease of at least 0.5 of SD score BMI (mean: −0.67; ∼30% of those who were overweight) is required to observe a significant improvement in insulin sensitivity (∼65% increase). No data concerning obese subjects with impaired glucose tolerance (IGT) were provided.

Given that type 2 diabetes in children, once considered rare, has become increasingly common in association with obesity and IGT represents the frequently missed link between insulin resistance and type 2 diabetes, it might be useful to study the effect of weight loss on glucose metabolism in children with IGT.

Fifteen severely obese children and adolescents with IGT were included in the study (mean age:...

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