Leah M Lipsky1, Benjamin Gee2, Aiyi Liu3, Tonja R Nansel2. 1. Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, North Bethesda, MD, United States. Electronic address: lipskylm@mail.nih.gov. 2. Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, North Bethesda, MD, United States. 3. Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, North Bethesda, MD, United States.
Abstract
AIMS: The impact of adiposity on glycemic control in type 1 diabetes patients has important implications for preventing complications. This study examined associations of glycemic outcomes with body mass index (BMI, kg/m(2)) and body composition in youth with type 1 diabetes. METHODS: This is a secondary analysis of an 18-month randomized controlled dietary intervention trial (N=136, baseline age=12.3±2.5y, HbA1c=8.1±1.0% (65±11mmol/mol)). Measured height and weight every 3months were abstracted from medical records. Body composition was assessed by dual energy X-ray absorptiometry (DXA) at baseline, 12 and 18months. Glycated hemoglobin (HbA1c) and glycemic variability assessed by masked 3-day continuous blood glucose monitoring (CGM) were obtained every 3months. 1,5-Anhydroglucitol (1,5-AG) was assessed every 6months. Adjusted random effects models for repeated measures estimated associations of time-varying BMI and body composition with time-varying glycemic outcomes. RESULTS: There was no treatment effect on glycemic outcomes. HbA1c was not associated with BMI or body composition indicators. 1,5-AG was inversely associated with BMI and adiposity indicators (%fat, trunk fat mass and trunk %fat), adjusting for developmental covariates. Adiposity indicators were positively associated with %glucose >180mg/dL and >126mg/dL when adjusting for developmental covariates, and %glucose >126mg/dL when additionally adjusting for diabetes-related covariates. Fewer consistent relationships were observed for 3-day mean glucose and %glucose <70.2mg/dL. BMI and body composition variables were not associated with standard deviation of glycemic values or mean amplitude of glycemic excursions. CONCLUSIONS: The role of greater BMI and adiposity in diabetes management in youth with type 1 diabetes may relate specifically to increased hyperglycemic excursions. Published by Elsevier Ireland Ltd.
RCT Entities:
AIMS: The impact of adiposity on glycemic control in type 1 diabetespatients has important implications for preventing complications. This study examined associations of glycemic outcomes with body mass index (BMI, kg/m(2)) and body composition in youth with type 1 diabetes. METHODS: This is a secondary analysis of an 18-month randomized controlled dietary intervention trial (N=136, baseline age=12.3±2.5y, HbA1c=8.1±1.0% (65±11mmol/mol)). Measured height and weight every 3months were abstracted from medical records. Body composition was assessed by dual energy X-ray absorptiometry (DXA) at baseline, 12 and 18months. Glycated hemoglobin (HbA1c) and glycemic variability assessed by masked 3-day continuous blood glucose monitoring (CGM) were obtained every 3months. 1,5-Anhydroglucitol (1,5-AG) was assessed every 6months. Adjusted random effects models for repeated measures estimated associations of time-varying BMI and body composition with time-varying glycemic outcomes. RESULTS: There was no treatment effect on glycemic outcomes. HbA1c was not associated with BMI or body composition indicators. 1,5-AG was inversely associated with BMI and adiposity indicators (%fat, trunk fat mass and trunk %fat), adjusting for developmental covariates. Adiposity indicators were positively associated with %glucose >180mg/dL and >126mg/dL when adjusting for developmental covariates, and %glucose >126mg/dL when additionally adjusting for diabetes-related covariates. Fewer consistent relationships were observed for 3-day mean glucose and %glucose <70.2mg/dL. BMI and body composition variables were not associated with standard deviation of glycemic values or mean amplitude of glycemic excursions. CONCLUSIONS: The role of greater BMI and adiposity in diabetes management in youth with type 1 diabetes may relate specifically to increased hyperglycemic excursions. Published by Elsevier Ireland Ltd.
Entities:
Keywords:
1,5-Anhydroglucitol; Adolescent; Body composition; Body mass index; Diabetes mellitus, type 1; Hemoglobin A glycosylated
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