Secular trends in BMI in a cohort of children with Type 1 diabetes in the first-year post diagnosis

Main Article Content

Danielle Kadishevich Adi Auerbach Carmit Avnon-Ziv Floris Levy Khademi, MD

Abstract

Background: Along with the global increase in the rates of overweight and obesity in the pediatric population, it is becoming more prevalent in children with type 1 diabetes. The presence of diabetes and obesity may further aggravate the long term outcome of these children.


Aims: Evaluate the secular change in BMI in children during the first year after the diagnosis of type 1 diabetes and identify variables affecting this change.


Methods: This is a retrospective cohort study conducted at the diabetes clinic at Shaare Zedek Medical Center. Demographic data was withdrawn from the patients' charts and included age, age at diagnosis, gender and ethnic origin. Clinical data included DKA at diagnosis, height, weight, and BMI at presentation and throughout the first year following diagnosis at several pre-determined time points.


Results: The study included 167 patients, 93 males. The average BMI-Z at presentation was -0.65 and increased to 0.35 after a year from diagnosis. The most pronounced increase in BMIZ occurred as expected in the first month (0.5-0.75), but it continued during the first year. At diagnosis, 16.6% of the children were underweight, 11.8% overweight and 2.7% obese. By the end of the first year, there were more overweight 28.5%, and obese 6.3% children. The lower the BMI-Z at diagnosis, the greater the weight gain observed at all-time points throughout the year. DKA at presentation was associated with a more significant weight gain in the first year using univariate analysis.  No correlation was found between the patients' gender or age at diagnosis and the degree of weight gain.


Conclusions: Continuous weight gain was observed throughout the first year after the diagnosis of diabetes, with a significant increase in the rate of overweight and obesity.

Keywords: Type 1 diabetes, BMI, Children, Obesity, overweight

Article Details

How to Cite
KADISHEVICH, Danielle et al. Secular trends in BMI in a cohort of children with Type 1 diabetes in the first-year post diagnosis. Medical Research Archives, [S.l.], v. 12, n. 4, apr. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5361>. Date accessed: 10 oct. 2024. doi: https://doi.org/10.18103/mra.v12i4.5361.
Section
Research Articles

References

1. Diabetes control and complications trial research group; Nathan D M, Genuth S, Lachin J, et al. The Effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329,977–86. DOI: 10.1056/NEJM1 99309303291401

2. Cengiz E, Danne t, Ahmad T, et al. ISPAD clinical practice consensus guidelines 2022: Insulin treatment in children and adolescents with diabetes. Pediatr Diabetes 2022;23:1277 -96. DOI: 10.1111/pedi.13442

3. The Diabetes control and complications trial research group. Influence of intensive diabetes treatment on body weight and composition of adults with type 1 diabetes in the diabetes control and complications trial. Diabetes Care 2001; 24:711–21, DOI: 10.233 7/diacare.24.10.1711

4. Leslie P, Jung RT, Isles TE, et al. Effect of optimal glycaemic control with continuous subcutaneous insulin infusion on energy expenditure in type I diabetes mellitus. Br Med J (Clin Res Ed)1986;293:1121–6.DOI: 10.1136/bmj.293.6555.1121.

5. Russell-Jones D, Khan R. Insulin-associated weight gain in diabetes -causes, effects and coping strategies. Diabetes Obes Metab 2007;9:799–812. DOI: 10.1111/j.1463-1326.2006.00686.x

6. Purnell JQ, Hokanson JE, Marcovina SM, Steffes MW, Cleary PA, Brunzell JD. Effect of excessive weight gain with intensive therapy of type 1 diabetes on lipid levels and blood pressure: Results from the DCCT. J Am Med Assoc 1998; 280:140–6. DOI: 10.1001/jama.2 80.2.140

7. Vurrali D, Jalilova L, Alijasifoglu A, et al. Cardiovascular risk factors in adolescents with type 1 diabetes: Prevalence and gender differences. J Clin Res Pediatr Endocrinol 2024; 16:11-20. DOI: 10.4274/jcrpe.galenos.2 023.2023-12-12.

8. Pines Corrales PJ, Sastre Marcos J, Lopez Gallardo G, et al. All- cause mortality and risk factors in patients with type 1 diabetes in Castilla-La Mancha, Spain. DIACAM 1 2010-2020 study. Prim Care diabetes 2024;18-59-64. DOI:10.1016/j.pcd.2023.11.003

9. Dicle Canorcu E, Hande Nur K, Gozmen O, et al. Early weigh gain after diagnosis may have an impact on remission status in children with new-onset type 1 diabetes mellitus. Journal of Diabetes 2023;15:1011-1019. DOI: 10.1111/1753-0407.13455

10. Baskaran C, Volkening LK, Diaz M, Laffel LM. A decade of temporal trends in overweight/obesity in youth with type 1 diabetes after the Diabetes Control and Complications Trial. Pediatr Diabetes 2015;16:263–70. DOI: 10.1111/pedi.12166

11. Manyanga T, Sellers EA, Wicklow BA, Doupe M, Fransoo R. Is the change in body mass index among children newly diagnosed with type 1 diabetes mellitus associated with obesity at transition from pediatric to adult care? Pediatr Diabetes 2016;17:599–607. DOI: 10.1111/pedi.12344

12. Newfield RS, Cohen D, Capparelli E V, Shragg P. Rapid weight gain in children soon after diagnosis of type 1 diabetes: is there room for concern? Pediatr Diabetes 2009;10:310–5. DOI: 10.1111/j.1399-5448.2008.00475.x

13. Köken ÖY, Kara C, Yılmaz GC, Aydın HM. Prevalence of obesity and metabolic syndrome in children with type 1 diabetes: A comparative assessment based on criteria established by the international diabetes federation, world health organisation and national cholesterol education program. J Clin Res Pediatr Endocrinol 2020;12:55–62. DOI: 10.4274/jcrpe.galenos.2019.2019.0048

14. Fröhlich-Reiterer EE, Rosenbauer J, Pozza SB-D, Hofer SE, Schober E, Holl RW; DPV-Wiss study group and German BMBF Competence Networks Diabetes Mellitus and Obesity. Predictors of increasing BMI during the course of diabetes in children and adolescents with type 1 diabetes: data from the German/Austrian DPV multicentre survey. Arch Dis Child 2014; 99:738–43. DOI: 10.1136/archdischild-2013-304237

15. De Vries L, Bar-Niv M, Lebenthal Y, et al. Changes in weight and BMI following the diagnosis of type 1 diabetes in children and adolescents. Acta Diabetol 2013;51:395–402. DOI: 10.1007/s00592-013-0524-4

16. Rosenfalck AM, Almdal T, Hilstead J, Madsbad S. Body composition in adults with Type 1 diabetes at onset and during the first year of insulin therapy. Diabet Med 2002; 5:417-23.DOI: 10.1046/j.1464-549.2002.00702.x.

17. Liu LL, Lawrence JM, Davis C, et al. Search for Diabetets in Youth study group. Prevalence of overweight and obesity in youth with diabetes in USA: The SEARCH for Diabetes in Youth Study. Pediatr Diabetes 2010;11:4–11. DOI: 10.1111/j.1399-5448.200 9.00519.x

18. Souza da cunha LV, Ramos Salles de Oliveira DC, de Oliveira Cardoso L, et al. The association between dietary pattern, obesity, and glycemic control of children and adolescents with type 1 diabetes mellitus. Nutrients 2024;16;364. DOI: 10.3390/nu16030364

19. DuBose SN, Hermann JM, Tamborlane w, et al. Obesity in youth with type 1 diabetes in Germany, Austria, and the United States. J Pediatr 2015;167:227-32e1 DOI: 10.1016/j. peds.2015.05.046.

20. Genua I, Franch-Nadal J, Navas E, et al. Obesity and related comorbidities in a large population-based cohort of subjects with type 1 diabetes in Catalonia. Front Endocrinol (Lausanne); 2022;13:1015614. DOI: 10 3389/ fendo.2022.105614

21. The Israel Center for Disease Control ICDC M of H. The ‘MABAT’ nutrition survey for ages 2-11. Ministry of Health; 2016.

22. The Israel Center for Disease Control ICDC M of H. The ‘MABAT’ nutrition survey for ages 12-18. 2016.

23. Davis NL, Bursell JDH, Evans WD, Warner JT, Gregory JW. Body composition in children with type 1 diabetes in the first year after diagnosis: Relationship to glycaemic control and cardiovascular risk. Arch Dis Child 2012; 97:312–5. DOI: 10.1136/archdischild-2011-300626