The high rate of overweight and obesity is prevalent in children and adolescents with Type 1 diabetes, emphasizes the need for developing further strategies to prevent and treat excess fat accumulation in Type 1 diabetes, according to a study published in Pediatric Diabetes.
According to the authors, 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.
They also indicate there is a lack of international data using the BMI standard deviation score of WHO.
How Was the Study Conducted?
In the study, the researchers evaluated 23,026 children with Type 1 diabetes for a minimum of one year, who were enrolled in the SWEET registry, a prospective collaboration of 55 pediatric diabetes centers aimed at gathering clinical outcome data.
The researchers used WHO BMI charts to calculate BMI standard deviation score (SDS). The researchers then 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.
Findings were adjusted for sex, age and duration of diabetes to assess the prevalence of overweight and obesity.
What Did They Find?
Among boys, the prevalence of underweight was 1.4%, the prevalence of normal weight was 69%, the prevalence of overweight was 22.3% and prevalence of obesity was 7.3%.
Among girls, the prevalence of underweight was 0.6%, the prevalence of normal weight was 65.4%, the prevalence of overweight was 27.2% and prevalence of obesity was 6.8%. Girls had a higher adjusted BMI SDS vs. boys.
Researchers observed that boys had a higher prevalence of obesity in the youngest age strata vs. girls, whereas the opposite was seen among children in the oldest age category.
Among children older than 10 years, girls had a higher prevalence of being overweight vs. boys whereas boys older than 10 years had a higher prevalence of underweight vs. girls.
Girls also had a higher adjusted HbA1c, but both boys and girls with obesity had a higher HbA1c vs. normal-weight children, according to the researchers.
Conclusions
The authors of the study conclude that one out of three children and adolescents with Type 1 diabetes was overweight or obese, whereas one out of 100 was underweight.
On average, females had higher BMI SDS than males and BMI SDS increased with diabetes duration.