Changes from 1986 to 2018 in the Prevalence of Obesity and Overweight, Metabolic Control and Treatment in Children with Type 1 Diabetes Mellitus

Abstract

Background: In recent decades, a global increase in the prevalence of childhood overweight and obesity has been observed in children and adolescents with type 1 diabetes.Methods: This retrospective, cross-sectional, population study examined three groups (1986, 2007, and 2018) of children and adolescents aged <16 years diagnosed with type 1 diabetes. Overweight and obesity were defined according to the World Health Organization recommendations.Results: The prevalence of overweight and obesity in diabetic children and adolescents was 30.2% (95% CI: 23.1-38.3). There was a significant increase from 1986 to 2007 (11.9% to 41.7%, p=0.002) and from 1986 to 2018 (11.9% to 34.8%, p=0.012), but no significant differences were found from 2007 to 2018 (41.7% to 34.8%, p=0.492). The age at diagnosis was lower in the group with excess body mass (p=0.037). No significant differences were observed in age (p=0.690), duration of diabetes (p=0.163), distribution according to sex (p=0.452), metabolic control (HbA1c, p=0.909), or insulin units kg/day (p=0.566), in diabetic patients with overweight or obesity. From 2007 to 2018, the use of insulin analogs (p=0.009) and a higher number of insulin doses (p=0.007) increased significantly, with no increase in the prevalence of overweight and obesity.Conclusions: The evolution of the prevalence of overweight and obesity in diabetic children and adolescents during the study period is a reflection of the epidemic of childhood obesity in a global obesogenic environment.