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Higher Risk of Excess Weight in Adolescents with Type 1 Diabetes

With already increased risk of weight gain in adolescents with type 1 diabetes, certain traits in these children can also be markers for even higher weight gain…. 

The purpose of this study was to evaluate factors that increase BMI in children and adolescents with type 1 diabetes (T1D) in a large multicenter survey. In general, weight gain among people with diabetes can be harmful in many ways as it can lead to complications.

Elke Frohlich-Reiterer and her colleague analyzed data collected from 248 diabetes centers in Germany and Austria. The total population studied was 12,774 of whom 53% were males and 47% females. The mean age was 13.4, mean diabetes duration was 4.7 years, and mean age at diabetes onset was 8.7. All the kids were under the age of 20. The children in the study were grouped by age: under 5, 5-10 years, 10-15 years, and 15-20 years. These data came from a standardized, prospective, computer-based documentation program known as the DPV database.

Based on multiple longitudinal regression analysis, being female, having low body mass index (BMI) at diabetes onset, having intensified insulin therapy, having higher insulin dose, having long diabetes duration, and beginning diabetes onset at an early age among girls were related to higher increase in BMI and weight gain (p < 0.01). Females who develop diabetes around puberty between the ages of 10-15 were also more likely to have weight gain. Using short acting insulin was also linked to greater weight gain in girls, whereas using long-acting insulin was linked to more weight gain in boys.

Insulin regimens and a multitude of other variables have been associated with weight gain in T1D patients. Overweight and obese individuals can exacerbate insulin resistance and further complicate the case. Extra care should be taken in properly managing diabetes in adolescents, especially girls, to limit weight gain and reduce overweight/obesity all together.

Practice Pearls:
  • Being female, having low (BMI) at diabetes onset, having intensified insulin therapy, having higher insulin dose, having long diabetes duration, and beginning diabetes onset at an early age among girls were related to increased weight gain
  • Girls who develop diabetes around puberty are at higher risk of weight gain
  • Short acting insulin was linked to greater weight gain in girls, whereas using long-acting insulin was linked to more weight gain in boys

Fröhlich-Reiterer E, Rosenbauer J, Pozza S, et al. Predictors of increasing BMI during the course of diabetes in children and adolescents with type 1 diabetes: data from the German/Austrian DPV multicenter survey. Archives of Disease in Childhood. 2015 June 5.