Endocrine Abstracts

Introduction: Children with type 1 diabetes mellitus (T1DM) are at increased risk of being overweight. Being overweight could be related to insulin requirements, female gender, and duration of diabetes. The aim of this study is to examine the Body Mass Index (BMI) of children and young people with T1DM at the Children’s Hospital for Wales and explore co-factors that may contribute to risk.

Methods: A retrospective review of all patients with T1DM attending the Children’s hospital for Wales from May 2016 to May 2019 was undertaken. Age and gender adjusted BMI (weight[kg]/height²[metres]) centile for the latest recorded visit was compared to HbA1c, insulin regimen, total daily insulin dose, duration of diabetes, and deprivation index.

Results: Overall BMI centile of children with T1DM in this population was high at 69 (95% CI 65–71). BMI centile was associated with daily insulin dose (r=0.24, P=0.01). On average those using pumps had a higher BMI centile and lower HbA1c respectively compared to those on MDI (74 (95% CI 68–79) vs 65 (95% CI 61–70) P=0.043 and 63 mmol/mol (95%CI 60–65) vs 71 mmol/mol (95% CI 68–74) P<0.0001). Children living in the most deprived quintile had a BMI 9 centiles higher than those living in the least deprived quintile (P=0.035). A multiple regression showed that a younger age at diagnosis, duration of diabetes, living in a higher level of deprivation, a higher total daily insulin dose, and usage of pumps, were all risk factors for a higher BMI (P<0.0001).

Conclusion: Children with T1DM have a higher BMI than the UK reference population. A higher BMI centile was associated with living in higher deprivation areas, a younger age of onset and more intensive insulin regimens. Being overweight is a risk factors for developing long-term adverse cardiovascular outcomes in T1DM and care should be taken to monitor weight carefully.