A study in The Journal of Pediatrics has revealed that children and young people with type 1 diabetes are more likely to be obese than their contemporaries without the condition.
The authors determined the BMI z-scores in young people aged 2–18 years with a diabetes duration of at least 1 year from two large national registries – the US T1D Exchange (n=11 435) and the German/Austrian Diabetes Prospective Follow-up registry (n=21 501). Participants in both registries had higher median BMI values than international (World Health Organization) and their respective national reference values. Around a third of the participants were classed as overweight or obese. Greater BMI z-scores were associated with higher HbA1c levels and more frequent episodes of severe hypoglycaemia.
Traditionally, people with type 1 diabetes have tended to be underweight, as imperfect blood glucose management led to glucose (and thus calorie) elimination through the urine. Now, however, as diabetes management has improved and food consumption has increased, people with the condition are also facing the risk of obesity.
The corresponding author, Stephanie DuBose (Jaeb Center for Health Research, Tampa, FL, USA), said: ‘Type 1 diabetes is extremely difficult to manage even under the best circumstances. Thus, the number of young people with the disease who have the added burden of excessive weight is disconcerting to say the least. These patients are at risk for serious complications, especially as they get older. This research underscores the need for physicians to educate their patients about the importance of maintaining a healthy weight as part of overall diabetes management.”
David Maahs, Co-Chair for Protocols and Publications with the Type 1 Diabetes Exchange, said: “The obesity problem in the US is well-known, but obesity’s effect on adolescents with type 1 diabetes is overlooked. These patients need to avoid excessive calories and get more physical activity. Addressing these issues as early as possible in a pediatric patient’s life will make healthy behaviours more likely to become lifelong habits, adopted well before the damage is done.” He also suggested that more research should be done to explore the potential weight loss benefits of various treatments, including metformin and glucagon-like peptide-1 receptor agonists, which are typically used to achieve glycaemic control in type 2 diabetes.
The study can be read in full here.
