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Overweight, obesity prevalent in youths with type 1 diabetes
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Additional strategies are needed to address the high rate of overweight and obesity in children and adolescents with type 1 diabetes, according to study data published in Pediatric Diabetes.
“To the best of our knowledge, there is a scarcity of available data on the prevalence and geographical distribution of underweight, overweight and obesity in large cohorts of children and adolescents with [type 1 diabetes],” Claudio Maffeis, MD, of the pediatric diabetes and metabolic disorders unit at the University of Verona in Italy, and colleagues wrote in the study background. “Apart from a study comparing underweight, overweight and obesity in children with [type 1 diabetes] conducted in Germany, Austria and the United States, there is a lack of international data using the BMI standard deviation score of WHO.”
In an international, cross-sectional study, the researchers evaluated 23,026 children with type 1 diabetes for at least 1 year, who were enrolled in the SWEET registry, a prospective collaboration of 55 pediatric diabetes centers aimed at improving the care of children with the disease through information sharing and gathering of clinical outcome data
The researchers used WHO BMI charts to calculate BMI standard deviation score (SDS). The researchers classified children as underweight (BMI-SDS < –2 SD); normal weight (2 SD BMI-SDS +1 SD) overweight (+1 SD < BMI-SDS +2 SD) or obese (BMI-SDS > +2 SD). Researchers evaluated metabolic profile via HbA1c, measured locally in each study site.
Treatment approach was categorized as conventional therapy ( 3 injection time points per day), intensified conventional therapy (4-8 injection time points daily) and insulin pump therapy.
Researchers used hierarchic regression models adjusted for sex, age and duration of diabetes to assess the prevalence of overweight and obesity.
Among boys, prevalence of underweight was 1.4%, prevalence of normal weight was 69%, prevalence of overweight was 22.3% and prevalence of obesity was 7.3%. Among girls, prevalence of underweight was 0.6%, prevalence of normal weight was 65.4%, prevalence of overweight was 27.2% and prevalence of obesity was 6.8%. Girls had a higher adjusted BMI SDS vs. boys (mean, 0.54 vs. 0.4; P < .0001).
Researchers observed that boys had a higher prevalence of obesity in the youngest age strata vs. girls (9.6% vs. 6.2%; P < .00001), whereas the opposite was seen among children in the oldest age category (6.2% vs. 7.8%, respectively; P < .0001).
Among children older than 10 years, girls had a higher prevalence of overweight vs. boys (28.2% vs. 21.5%; P < .05), whereas boys older than 10 years had a higher prevalence of underweight vs. girls (1.65% vs. 0.67%; P < .0001).
Girls also had a higher adjusted HbA1c (mean, 8.2% vs. 8.06%; P < .0001), but both boys and girls with obesity had a higher HbA1c vs. normal-weight children (P < .05), according to the researchers.
“One out of three children and adolescents with type 1 diabetes was overweight or obese, whereas one out of 100 was underweight,” the researchers wrote. “On average, females had higher BMI SDS than males and BMI SDS increased with diabetes duration.” – by Jennifer Byrne
Disclosures: The authors report no relevant financial disclosures.
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