Aim Overweight and obesity are frequently reported in young persons with type 1 diabetes, however its relative magnitude in comparison to the general population is not well understood. This study compared the prevalence of overweight and obesity in young persons with type 1 diabetes to a reference population and explored possible associated factors, including gender, age, HbA1c, insulin regimen, age at diagnosis, diabetes duration, socio‐economic status and cardiovascular disease risk factors. Methods A cross‐sectional review was undertaken of data collected from youth (3–17 years) in 2016 and young adults (18–30 years) in 2015 with a diagnosis of type 1 diabetes for > 3 months attending diabetes centres in Newcastle, Australia. Rates of overweight and obesity were compared with matched population survey results. Results Data from 308 youth and 283 young adults were included. In girls, significantly higher prevalence of overweight and obesity were seen in the 5–8 (43% vs. 18%), 13–16 (41% vs. 27%), 18–24 (46% vs. 34%) and 25–30 (60% vs. 43%) years age groups; whereas in boys increased prevalence was observed in the 5–8 years age group only (41% vs. 18%). Rates of overweight and obesity increased with age across sexes. In youth, BMI standard deviation score was correlated with socio‐economic status, insulin regimen, blood pressure and blood lipids (P < 0.05). In adults, BMI was positively associated with blood pressure, and longer diabetes duration (P < 0.02). Conclusions Overweight and obesity are over‐represented in young persons with type 1 diabetes, particularly girls. As overweight is associated with other cardiovascular disease markers early intervention is paramount.

High rates of overweight and obesity are shown across paediatric type 1 diabetes (T1D) cohorts, including 32% from the international SWEET registry 1 and 33% from the Australasian Diabetes Data Network registry. 2 A greater body mass index standard deviation score (BMI-SDS) was observed in youth from the Diabetes Prospective Follow-up cohort compared with a national reference

Studies on how a gluten free (GF) diet in youth with T1D and CD impacts glycemic control, quality of life (QoL) and nutrient intake are limited. The study aim was to determine the effects of the introduction of a GF diet in children with T1D and newly diagnosed CD on glycemic control, nutrient intake, QoL and body mass index (BMI). Subjects wore a continuous glucose monitor for 12 days and completed a 4-day food record at baseline and 3 months after implementing a GF diet. Participants and one parent completed the PedsQL questionnaire at baseline and 3 months. Ten children participated (age 10.8y ± 3.3, 40% male, BMI Z-score 0.5 ± 0.6, diabetes duration 2.2y ± 2.6 (50% with diabetes duration of &lt;12 months), 60% on multiple daily injections, 20% on insulin pump therapy and 20% on twice-daily injections, HbA1c 6.0 ± 1.1%). BMI Z-score (0.4 vs. 0.5, p=0.73), glycemic variability % CV (40.4% vs. 40.2%, p=0.94), HbA1c (6.0% vs. 5.8%, p=0.56), percentage glucose time above target range &gt;180mg/dL (30.3% vs. 36.1%, p=0.09) and below target range &lt;70mg/dL (7.2% vs. 7.9%, p=0.76) did not change significantly from baseline to 3-months, however time in range (TIR) 70-180mg/dL (62.6% vs. 56.0%, p=0.02) was significantly lower at 3 months. Intake of fibre (18g vs. 16g, p=0.40), iron (9g vs. 8g, p=0.35), calcium (826mg vs. 791mg, p=0.75) and saturated fat (13.5% vs. 14.0%, p=0.77) were not significantly different from baseline to 3 months. QoL score was not significantly different for parents (63.2 vs. 67.4, p=0.08) or children (56.8 vs. 63.5, p=0.08) from baseline to 3 months. This study suggests that implementation of a GF diet in children with T1D does not adversely impact glycemic control, nutrient intake, QoL or BMI Z-score. The only change in glycemic control reduced TIR at 3 months which may represent changing insulin requirements with gut healing and the end of the remission phase of T1D. Disclosure A. L. Marlow: None. B. R. King: None. S. E. Johnson: Consultant; Self; Medtronic. S. K. Binkowski: None. J. Fairchild: None. E. A. Davis: None. C. E. Smart: None. Funding Australasian Paediatric Endocrine Group; Pfizer Inc. (WI205278)

Recent research has demonstrated an increased rate of overweight and obesity in children with T1D. The Australasian Diabetes Data Network found that 33% of children and adolescents with T1D were overweight or obese [7] compared to 25% of the pediatric population in the Australian National Health Survey [8]. Youth with T1D from the Diabetes Prospective Study (DPV) in Europe and the Type 1 Diabetes Exchange (T1DX) in America had a higher median body mass index standard deviation score (BMI-SDS) is compared to respective national reference samples [9]. The SEARCH for diabetes in youth study found significantly higher rates of overweight but not obesity in young people with T1D (3-19 years) compared to the general US population [10]. Stratification by age and gender revealed that females aged 12-19years with T1D had significantly higher rates of combined overweight or obesity compared to the population reference (36.5% and 29.1%, respectively). Interestingly, the opposite was true in boys aged 12-19 years with T1D, where the rates in the population reference were significantly higher (28.8% and 34.6%, respectively) [10].