Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry
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 23026 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).
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 (meanSEM: 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 <10years), 0.39 +/- 0.04 (10 to <13 years), 0.55 +/- 0.04 (13 to <16 years). BMI-SDS increased by diabetes duration (<2years: 0.38 +/- 0.05, 2 to <5 years: 0.44 +/- 0.05, and 5years: 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.