Background

Pediatric obesity is associated with increased risk of executive function (EF) deficits that contribute to poorer obesity treatment response. Obesity-associated insulin resistance has been linked to EF deficits in adults. Thus, genetic risk for developing insulin resistance, assessed by parental Type 2 Diabetes (T2DM) history, may contribute to poorer EF in children. This relation may have important clinical implications, as it may serve as a target to improve obesity treatment response.

Methods

17 children aged 8-12 with obesity were recruited from outpatient medical clinics. Demographics and medical history were assessed via parent questionnaire. EF was assessed via the NIH Toolbox Cognitive Battery. Analyses included t-Tests for independent means to examine effect sizes of Parent T2DM on child and parent EF.

Results

Children were 76% female and 64.7% African American. Those with caregiver history of T2DM showed poorer performance across domains (Hedge’s g: Inhibition = -1.43*, Cognitive Flexibility = -0.66, Processing Speed = -1.01, Working Memory = -0.65). Adults with T2DM showed better performance across all domains except one (Hedge’s g: Inhibition = 0.30, Cognitive Flexibility = 2.14, Processing Speed = -0.42, Working Memory = 0.14).

Conclusions

Exploratory results show parent T2DM history may contribute to poorer child EF. T2DM in these parents was associated with slightly improved parent cognitive performance, which may have been related to anti-diabetic medication taken, consistent with current literature. If this finding is replicated, pediatric obesity treatment may benefit from targeting decreased insulin sensitivity and EF deficits.