Endocrine Abstracts

JOINT230

Background: Type 1 Diabetes Mellitus (T1DM) is characterized by insulin deficiency, leading to a catabolic state at diagnosis. While intensive insulin therapy facilitates a rapid and complex reshaping of body composition, the effects on body fat and lean mass, particularly in children, remain underexplored, especially in the Indian context. This study aims to evaluate the impact of insulin therapy on body composition in children with newly diagnosed T1DM over a 10–12-week period and compare it with healthy controls.

Methods: 42 children with newly diagnosed T1DM (aged 5–18 years) and 42 healthy controls were included. Clinical assessments, anthropometry, and Body Impedance Analysis (BIA) were performed at diagnosis and after 10–12 weeks for cases, and once for controls. BIA parameters analysed were body fat mass (FM), fat-free mass (FFM), percent fat mass (%FM), percent fat-free mass (%FFM), fat mass index (FMI), and fat-free mass index (FFMI).

Results: At diagnosis, children with T1DM had significantly lower weight Z-scores (-0.58), BMI Z-scores (-0.87), and Triceps skinfold thickness (TSFT) (-4.31) compared to controls. BIA revealed reduced FM (-2.90), FMI (-1.71), and %FM (-9.13%) in the T1DM group. The FFM and FFMI showed no significant difference between the groups, though %FFM was higher in T1DM children indicating a relatively lower proportion of fat mass in cases. After 10-12 weeks of insulin therapy, children with T1DM demonstrated significant increases in weight Z-scores (0.44), BMI Z-scores (0.59), TSFT (0.35 mm), FM (0.77 kg), FMI (0.44 kg/m²), and %FM (2.07%). FFM (1.03 kg) and FFMI (0.59kg/m²) also increased, while %FFM decreased, suggesting a shift towards increased fat storage On follow-up, T1DM children matched controls in weight and BMI-Z-scores but had lower FM (-2.13 kg), FMI (-1.28 kg/m²), and %FM (-7.06%) with higher %FFM (6.77%).

Conclusion: Children with newly diagnosed T1DM exhibit lower body fat mass and BMI at diagnosis, primarily due to insulin deficiency. Insulin therapy leads to an increase in both fat and fat-free mass, with a greater impact on FM, but could not match healthy controls by 10–12 weeks, particularly in terms of fat mass. These findings highlight the importance of addressing body composition changes in children with T1DM to mitigate long-term cardiovascular and skeletal health risks. Future studies with longer follow-up periods are needed to better understand the long-term effects of insulin therapy on body composition in children with T1DM, particularly in the Indian population.