Long-term body weight trajectories and metabolic control in type 1 diabetes patients on insulin pump or multiple daily injections: A 10-year retrospective controlled study

Alderisio, Antonio; Bozzetto, Lutgarda; Franco, Luca; Riccardi, Gabriele; Rivellese, Angela Albarosa; Annuzzi, Giovanni

doi:10.1016/j.numecd.2019.06.008

Cited by 21 publications

(13 citation statements)

References 21 publications

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“…An important finding of this retrospective analysis concerns the changes in body weight. In line with the increase observed in an observational study with an even longer duration, 13 in this study, weight increased by about 0.5 kg per year in patients followed by individual visits. In contrast, weight remained stable in patients followed by group visits.…”

Section: Discussionsupporting

confidence: 91%

Beneficial effects on body weight of group vs individual care in adults with type 1 diabetes on advanced technologies

Franco

Bozzetto

Angelis

et al. 2021

Health Science Reports

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Rationale and aims Outpatient group visits in diabetes care have several potential advantages and can be simplified by the new technologies. The aim of this study was to assess feasibility and effectiveness of group visits vs individual visits in adults with type 1 diabetes on insulin pump therapy (continuous subcutaneous insulin infusion, CSII) and continuous glucose monitoring (CGM). Methods Outpatient setting for group visits (2‐hour duration, quarterly, 6‐8 patients) was the projection on giant screen of each patient's CGM and insulin pump data, with interactive discussion moderated by a diabetologist. Anthropometric measures and glycemic control (HbA1c) were assessed before and after a mean observation period of 4.4 ± 1.2 years (mean ± standard deviation, M ± SD) in CSII patients followed by group visits (GROUP) or individual visits (INDIVIDUAL) between 2013 and 2019. Results At the beginning of the observation, GROUP and INDIVIDUAL cohorts were strictly matched for gender (M/F = 37/35 and 37/35), age, diabetes duration, body mass index (BMI), CSII duration, and HbA1c level. HbA1c levels did not change significantly between beginning and end of observation in either cohort (GROUP 7.54 ± 0.80% and 7.60 ± 0.79%, P = .585; INDIVIDUAL 7.73 ± 1.27% and 7.60 ± 1.08%, P = .281) (time*visit effect P = .232, two‐way repeated measures analysis of variance [ANOVA]). Body weight remained unchanged in the GROUP cohort (73.2 ± 14.0 vs 73.8 ± 14.8 kg, P = .361), while it increased in the INDIVIDUAL cohort (70.3 ± 13.5 vs 73.0 ± 13.7 kg, P < 0.001) (time*visit effect P = .009). Conclusions Group care is feasible in adult patients with type 1 diabetes using new technologies. Group visits can be beneficial in inducing lifestyle changes, as indicated by the favorable effects observed on body weight trend.

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Section: Discussionsupporting

confidence: 91%

Beneficial effects on body weight of group vs individual care in adults with type 1 diabetes on advanced technologies

Franco

Bozzetto

Angelis

et al. 2021

Health Science Reports

Self Cite

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“…To address these issues, the concept of “annual BMI change” was applied in the present study to provide a standard for body weight management in interpregnancy care/counseling; annual BMI change would be preferable to total BMI change as the former would help set more realistic goals with an explicit timeframe. Moreover, “annual BMI change” has already been beneficial in various medical and healthcare fields, including those related to oncology 22 , 23 , CVD risks 24 , 25 , severe obstructive sleep apnea 26 , and diabetes mellitus 27 , 28 . However, no report has reported the association between the annual BMI change and HDP risk.…”

Section: Introductionmentioning

confidence: 99%

Annual body mass index gain and risk of hypertensive disorders of pregnancy in a subsequent pregnancy

Tano

Kotani

Ushida

et al. 2021

Sci Rep

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Weight gain during interpregnancy period is related to hypertensive disorders of pregnancy (HDP). However, in interpregnancy care/counseling, the unpredictability of the timing of the next conception and the difficulties in preventing age-related body weight gain must be considered while setting weight management goals. Therefore, we suggest considering the annual change in the body mass index (BMI). This study aimed to clarify the association between annual BMI changes during the interpregnancy period and HDP risk in subsequent pregnancies. A multicenter retrospective study of data from 2009 to 2019 examined the adjusted odds ratio (aOR) of HDP in subsequent pregnancies. The aORs in several annual BMI change categories were also calculated in the subgroups classified by HDP occurrence in the index pregnancy. This study included 1,746 pregnant women. A history of HDP (aOR, 16.76; 95% confidence interval [CI], 9.62 − 29.22), and annual BMI gain (aOR, 2.30; 95% CI, 1.76 − 3.01) were independent risk factors for HDP in subsequent pregnancies. An annual BMI increase of ≥ 1.0 kg/m2/year was related to HDP development in subsequent pregnancies for women without a history of HDP. This study provides data as a basis for interpregnancy care/counseling, but further research is necessary to validate our findings and confirm this relationship.

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“…The incorporation of the new technology of continuous subcutaneous insulin infusion (CSII) in T1D treatment has shown no clinical benefit over multiple daily injections, in terms of weight outcomes in newly diagnosed children and in young patients with T1D, either during the first year of insulinization 59 or over a 10-year follow-up. 60 …”

Section: Treatment Of Obesity In T1d: Challenges and Opportunitiesmentioning

confidence: 99%

Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges

Vilarrasa¹,

José²,

Rubio³

et al. 2021

DMSO

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Obesity affects large numbers of patients with type 1 diabetes (T1D) across their lifetime, with rates ranging between 2.8% and 37.1%. Patients with T1D and obesity are characterized by the presence of insulin resistance, of high insulin requirements, have a greater cardiometabolic risk and an enhanced risk of developing chronic complications when compared to normal-weight persons with T1D. Dual treatment of obesity and T1D is challenging and no specific guidelines for improving outcomes of both glycemic control and weight management have been established for this population. Nevertheless, although evidence is scarce, a comprehensive approach based on a balanced hypocaloric diet, physical activity and cognitive behavioral therapy by a multidisciplinary team, expert in both obesity and diabetes, remains as the best clinical practice. However, weight loss responses with lifestyle changes alone are limited, so in the “roadmap” of the treatment of obesity in T1D, it will be helpful to include anti-obesity pharmacotherapy despite at present there is a lack of evidence since T1D patients have been excluded from anti-obesity drug clinical trials. In case of severe obesity, bariatric surgery has proven to be of benefit in obtaining a substantial and long-term weight loss and reduction in cardiovascular risk. The near future looks promising with the development of new and more effective anti-obesity treatments and strategies to improve insulin resistance and oxidative stress. Advances in precision medicine may help individualize and optimize the medical management and care of these patients. This review, by gathering current evidence, highlights the need of solid knowledge in all facets of the treatment of patients with obesity and T1D that can only be obtained through high quality well-designed studies.

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Long-term body weight trajectories and metabolic control in type 1 diabetes patients on insulin pump or multiple daily injections: A 10-year retrospective controlled study

Cited by 21 publications

References 21 publications

Beneficial effects on body weight of group vs individual care in adults with type 1 diabetes on advanced technologies

Beneficial effects on body weight of group vs individual care in adults with type 1 diabetes on advanced technologies

Annual body mass index gain and risk of hypertensive disorders of pregnancy in a subsequent pregnancy

Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges

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