Claudio Maffeis1, Niels H Birkebaek2, Maia Konstantinova3, Anke Schwandt4,5, Andriani Vazeou6, Kristina Casteels7,8, Sujata Jali9, Catarina Limbert10, Auste Pundziute-Lycka11, Peter Toth-Heyn12, Carine de Beaufort13, Zdenek Sumnik14, Valentino Cherubini15, Jannet Svensson16, Daniele Pacaud17, Christina Kanaka-Gantenbein18, Shlomit Shalitin19,20, Natasa Bratina21, Ragnar Hanas22, Guy T Alonso23, Luxmi Poran24, Ana L Pereira25, Marco Marigliano1. 1. Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, University City Hospital, Verona, Italy. 2. Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark. 3. Clinic for Endocrinology, Diabetes and Genetics, Medical University Sofia, University Pediatric Hospital, Sofia, Bulgaria. 4. Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany. 5. German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany. 6. Diabetes Center, P & A Kyriakou Children's Hospital, Athens, Greece. 7. Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium. 8. Department of Development and Regeneration, University of Leuven, Leuven, Belgium. 9. KLE Diabetes Centre, KLE University JNMC and KLE'S Dr. Prabhakar Kore Hospital & MRC, Belagavi, India. 10. Hospital Dona Estefânia, Unit of Pediatric Endocrinology and Diabetes, Lisbon, Portugal. 11. Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden. 12. Ist. Department of Pediatrics, Semmelweis University, Budapest, Hungary. 13. Deccp, Pediatric Clinic/Centre Hospitalier de Luxembourg, Luxembourg, Grand Duche de Luxembourg. 14. Department of Pediatrics, Motol University Hospital, Prague, Czech Republic. 15. Department of Women's and Children Health, Salesi Hospital, Ancona, Italy. 16. Department of Pediatric and adolescents, Copenhagen University hospital, Herlev, Denmark. 17. Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada. 18. Diabetes Center, First Department of Pediatrics, Medical School,National and Kapodistrian University of Athens, Agia Sophia Children's Hospital, Athens, Greece. 19. The Jesse Z. and Lea Shafer Institute of Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. 20. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 21. University Children's Hospital, Department of Endocrinology, Diabetes and Metabolic Diseases, Ljubljana, Slovenia. 22. The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden and NU Hospital Group, Uddevalla, Sweden. 23. Barbara Davis Center, University of Colorado, Aurora, Colorado. 24. General Private Practitioner at T1diams, Mauritius, Island. 25. APDP-Diabetes Portugal, Department of Pediatric and adolescents, Lisbon, Portugal.
Abstract
OBJECTIVE: To assess the prevalence of underweight (UW), overweight (OW), and obesity in children and adolescents with type 1 diabetes (T1D). METHODS: An international cross-sectional study including 23 026 T1D children (2-18 years, duration of diabetes ≥1 year) participating in the SWEET prospective, multicenter diabetes registry. Body mass index SD score (BMI-SDS) was calculated using the World Health Organization BMI charts. Children were categorized as UW (BMI-SDS < -2SD), OW (+1SD < BMI-SDS ≤ +2SD), and obese (OB) (BMI-SDS > +2SD). Hierarchic regression models were applied with adjustment for sex, age, and duration of diabetes. RESULTS: The prevalence of UW, OW, and obesity was: 1.4%, 22.3%, and 7.3% in males and 0.6%, 27.2%, and 6.8% in females. Adjusted BMI-SDS was significantly higher in females than in males (mean ± SEM: 0.54 ± 0.05 vs 0.40 ± 0.05, P < 0.0001). In males, BMI-SDS significantly decreased by age (P < 0.0001) in the first three age categories 0.61 ± 0.06 (2 to <10 years), 0.47 ± 0.06 (10 to <13 years), 0.34 ± 0.05 (13 to <16 years). In females, BMI-SDS showed a U-shaped distribution by age (P < 0.0001): 0.54 ± 0.04 (2 to <10 years), 0.39 ± 0.04 (10 to <13 years), 0.55 ± 0.04 (13 to <16 years). BMI-SDS increased by diabetes duration (<2 years: 0.38 ± 0.05, 2 to <5 years: 0.44 ± 0.05, and ≥5 years: 0.50 ± 0.05, P < 0.0001). Treatment modality did not affect BMI-SDS. Adjusted HbA1c was significantly higher in females than in males (8.20% ± 0.10% vs 8.06% ± 0.10%, P < 0.0001). In both genders, the association between HbA1c and BMI-SDS was U-shaped with the highest HbA1c in the UW and obesity groups. CONCLUSIONS: The high rate of OW and obesity (31.8%) emphasize the need for developing further strategies to prevent and treat excess fat accumulation in T1D.
OBJECTIVE: To assess the prevalence of underweight (UW), overweight (OW), and obesity in children and adolescents with type 1 diabetes (T1D). METHODS: An international cross-sectional study including 23 026 T1D children (2-18 years, duration of diabetes ≥1 year) participating in the SWEET prospective, multicenter diabetes registry. Body mass index SD score (BMI-SDS) was calculated using the World Health Organization BMI charts. Children were categorized as UW (BMI-SDS < -2SD), OW (+1SD < BMI-SDS ≤ +2SD), and obese (OB) (BMI-SDS > +2SD). Hierarchic regression models were applied with adjustment for sex, age, and duration of diabetes. RESULTS: The prevalence of UW, OW, and obesity was: 1.4%, 22.3%, and 7.3% in males and 0.6%, 27.2%, and 6.8% in females. Adjusted BMI-SDS was significantly higher in females than in males (mean ± SEM: 0.54 ± 0.05 vs 0.40 ± 0.05, P < 0.0001). In males, BMI-SDS significantly decreased by age (P < 0.0001) in the first three age categories 0.61 ± 0.06 (2 to <10 years), 0.47 ± 0.06 (10 to <13 years), 0.34 ± 0.05 (13 to <16 years). In females, BMI-SDS showed a U-shaped distribution by age (P < 0.0001): 0.54 ± 0.04 (2 to <10 years), 0.39 ± 0.04 (10 to <13 years), 0.55 ± 0.04 (13 to <16 years). BMI-SDS increased by diabetes duration (<2 years: 0.38 ± 0.05, 2 to <5 years: 0.44 ± 0.05, and ≥5 years: 0.50 ± 0.05, P < 0.0001). Treatment modality did not affect BMI-SDS. Adjusted HbA1c was significantly higher in females than in males (8.20% ± 0.10% vs 8.06% ± 0.10%, P < 0.0001). In both genders, the association between HbA1c and BMI-SDS was U-shaped with the highest HbA1c in the UW and obesity groups. CONCLUSIONS: The high rate of OW and obesity (31.8%) emphasize the need for developing further strategies to prevent and treat excess fat accumulation in T1D.
Authors: María Teresa Pastor-Fajardo; María Teresa Fajardo-Giménez; Vicente María Bosch-Giménez; José Pastor-Rosado Journal: BMC Pediatr Date: 2022-05-12 Impact factor: 2.567
Authors: Ida Pastore; Andrea Mario Bolla; Laura Montefusco; Maria Elena Lunati; Antonio Rossi; Emma Assi; Gian Vincenzo Zuccotti; Paolo Fiorina Journal: Int J Mol Sci Date: 2020-07-12 Impact factor: 5.923
Authors: Evgenia Gourgari; Jeanette M Stafford; Ralph D'Agostino; Lawrence M Dolan; Jean M Lawrence; Santica Marcovina; Lina Merjaneh; Amy K Mottl; Amy S Shah; Dana Dabelea Journal: Pediatr Diabetes Date: 2020-05-05 Impact factor: 3.409
Authors: Michael R Kosorok; Elizabeth J Mayer-Davis; Anna R Kahkoska; Crystal T Nguyen; Xiaotong Jiang; Linda A Adair; Shivani Agarwal; Allison E Aiello; Kyle S Burger; John B Buse; Dana Dabelea; Lawrence M Dolan; Giuseppina Imperatore; Jean Marie Lawrence; Santica Marcovina; Catherine Pihoker; Beth A Reboussin; Katherine A Sauder Journal: BMJ Open Diabetes Res Care Date: 2020-01