Correlates of overweight and obesity in 5529 adolescents with type 1 diabetes: The T1D Exchange Clinic Registry

Abstract

Aims To describe the prevalence of overweight and obesity in adolescents with type 1 diabetes (T1D) and to examine the associations among socio-demographic, clinical, and self-management factors by weight status. Methods We analyzed baseline data obtained from 5,529 adolescents with T1D (mean age=15.4±1.4 years, 51.8% male, 77.9% white, mean HbA1c=8.7±1.8%; 72 mmol/mol) from the T1D Exchange Clinic Registry. We examined correlates of weight status using multinomial logistic regression analyses. Results Overweight (22.9%) and obesity (13.1%) were prevalent in the overall sample and was highest among girls (40.8%) and adolescents of Hispanic/Latino race/ethnicity (46.1%). Female gender, older age, annual household income <$35,000 (vs. ≥$200,000), high school parental educational attainment (vs. ≥graduate degree), lower HbA1c, longer duration of T1D, higher amount of insulin, and a recent visit with an allied healthcare provider were independently and significantly associated with higher odds of overweight or obesity. Adolescents who self-rated their health as fair/poor (vs. excellent) had the highest odds of obesity (OR 3.92, 95% CI 2.53–6.06). Conclusions Overweight/obesity is prevalent among adolescents with T1D, especially among girls and those of diverse race/ethnicity. Some of these factors may be amenable to remediation and point to subgroups that can benefit from obesity prevention and management efforts.

Biopsychosocial Aspects of Weight Management in Type 1 Diabetes: a Review and Next Steps

“…The T1D Exchange recently documented that 36% of adolescents with T1D are overweight/obese [20, 21••], which is consistent with the SEARCH for Diabetes in Youth Study [22] and other US T1D samples [23, 24] but higher than the general population [25]. In addition, Canadian and Polish studies of children and adolescents with T1D found that 35 and 30%, respectively, were overweight/obese [26, 27].…”

“…Many studies have shown that girls and women with T1D are more likely to be overweight and/or obese than are boys and men [21••, 24, 27, 28]. However, Duca and colleagues recently reported that 68 and 59% of men and women were in the overweight/obese weight categories, respectively, with more men classified as obese and more women as overweight [29].…”

“…The T1D Exchange showed that in adolescents with T1D, the highest rates of combined overweight/obese status occur in Hispanic/Latino participants [21••]. Moreover, Black/African American participants had the highest rates of obesity (18%), whereas Hispanic/Latino participants had the highest representation in the overweight status (30%) [21••].…”

“…The T1D Exchange showed that in adolescents with T1D, the highest rates of combined overweight/obese status occur in Hispanic/Latino participants [21••]. Moreover, Black/African American participants had the highest rates of obesity (18%), whereas Hispanic/Latino participants had the highest representation in the overweight status (30%) [21••]. In addition, older age, being of Hispanic/Latino race/ethnicity, having a parent with high school education or lower [24], and lower household income have been shown to be related to overweight/obese status [21••].…”

Paediatric obesity appears to lower the risk of diabetes if selection bias is ignored

“…In fact, there is much more overlap than those classic divisions suggest. A database of >5500 adolescents with type 1 diabetes found that 23% were overweight and 13% were obese 28. Furthermore, in youth with type 2 diabetes, the mean age of onset is 13.5 years 29.…”