Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry

Claudio Maffeis; Niels H Birkebaek; Maia Konstantinova; Anke Schwandt; Andriani Vazeou; Kristina Casteels; Sujata Jali; Catarina Limbert; Auste Pundziute-Lycka; Peter Toth-Heyn; Carine de Beaufort; Zdenek Sumnik; Valentino Cherubini; Jannet Svensson; Daniele Pacaud; Christina Kanaka-Gantenbein; Shlomit Shalitin; Natasa Bratina; Ragnar Hanas; Guy T Alonso; Luxmi Poran; Ana L Pereira; Marco Marigliano; SWEET Study Group

doi:10.1111/pedi.12730

Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry

Claudio Maffeis, Niels H Birkebaek, Maia Konstantinova, Anke Schwandt, Andriani Vazeou, Kristina Casteels, Sujata Jali, Catarina Limbert, Auste Pundziute-Lycka, Peter Toth-Heyn, Carine de Beaufort, Zdenek Sumnik, Valentino Cherubini, Jannet Svensson, Daniele Pacaud, Christina Kanaka-Gantenbein, Shlomit Shalitin, Natasa Bratina, Ragnar Hanas, Guy T AlonsoLuxmi Poran, Ana L Pereira, Marco Marigliano, SWEET Study Group

Department of Clinical Medicine

21 Citations (Scopus)

Abstract

Objective: To assess the prevalence of underweight (UW), overweight (OW), and obesity in children and adolescents with type 1 diabetes (T1D). Methods: An international cross-sectional study including 23 026 T1D children (2-18 years, duration of diabetes ≥1 year) participating in the SWEET prospective, multicenter diabetes registry. Body mass index SD score (BMI-SDS) was calculated using the World Health Organization BMI charts. Children were categorized as UW (BMI-SDS < −2SD), OW (+1SD < BMI-SDS ≤ +2SD), and obese (OB) (BMI-SDS > +2SD). Hierarchic regression models were applied with adjustment for sex, age, and duration of diabetes. Results: The prevalence of UW, OW, and obesity was: 1.4%, 22.3%, and 7.3% in males and 0.6%, 27.2%, and 6.8% in females. Adjusted BMI-SDS was significantly higher in females than in males (mean ± SEM: 0.54 ± 0.05 vs 0.40 ± 0.05, P < 0.0001). In males, BMI-SDS significantly decreased by age (P < 0.0001) in the first three age categories 0.61 ± 0.06 (2 to <10 years), 0.47 ± 0.06 (10 to <13 years), 0.34 ± 0.05 (13 to <16 years). In females, BMI-SDS showed a U-shaped distribution by age (P < 0.0001): 0.54 ± 0.04 (2 to <10 years), 0.39 ± 0.04 (10 to <13 years), 0.55 ± 0.04 (13 to <16 years). BMI-SDS increased by diabetes duration (<2 years: 0.38 ± 0.05, 2 to <5 years: 0.44 ± 0.05, and ≥5 years: 0.50 ± 0.05, P < 0.0001). Treatment modality did not affect BMI-SDS. Adjusted HbA1c was significantly higher in females than in males (8.20% ± 0.10% vs 8.06% ± 0.10%, P < 0.0001). In both genders, the association between HbA1c and BMI-SDS was U-shaped with the highest HbA1c in the UW and obesity groups. Conclusions: The high rate of OW and obesity (31.8%) emphasize the need for developing further strategies to prevent and treat excess fat accumulation in T1D.

Original language	English
Journal	Pediatric Diabetes
Volume	19
Issue number	7
Pages (from-to)	1211-1220
ISSN	1399-543X
DOIs	https://doi.org/10.1111/pedi.12730
Publication status	Published - Nov 2018

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Maffeis, C., Birkebaek, N. H., Konstantinova, M., Schwandt, A., Vazeou, A., Casteels, K., Jali, S., Limbert, C., Pundziute-Lycka, A., Toth-Heyn, P., de Beaufort, C., Sumnik, Z., Cherubini, V., Svensson, J., Pacaud, D., Kanaka-Gantenbein, C., Shalitin, S., Bratina, N., Hanas, R., ... SWEET Study Group (2018). Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry. Pediatric Diabetes, 19(7), 1211-1220. https://doi.org/10.1111/pedi.12730

Maffeis, C, Birkebaek, NH, Konstantinova, M, Schwandt, A, Vazeou, A, Casteels, K, Jali, S, Limbert, C, Pundziute-Lycka, A, Toth-Heyn, P, de Beaufort, C, Sumnik, Z, Cherubini, V, Svensson, J, Pacaud, D, Kanaka-Gantenbein, C, Shalitin, S, Bratina, N, Hanas, R, Alonso, GT, Poran, L, Pereira, AL, Marigliano, M & SWEET Study Group 2018, 'Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry', Pediatric Diabetes, vol. 19, no. 7, pp. 1211-1220. https://doi.org/10.1111/pedi.12730

@article{abbb6045dfb442b5adba7fa18f794268,

title = "Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry",

abstract = "Objective: To assess the prevalence of underweight (UW), overweight (OW), and obesity in children and adolescents with type 1 diabetes (T1D). Methods: An international cross-sectional study including 23 026 T1D children (2-18 years, duration of diabetes ≥1 year) participating in the SWEET prospective, multicenter diabetes registry. Body mass index SD score (BMI-SDS) was calculated using the World Health Organization BMI charts. Children were categorized as UW (BMI-SDS < −2SD), OW (+1SD < BMI-SDS ≤ +2SD), and obese (OB) (BMI-SDS > +2SD). Hierarchic regression models were applied with adjustment for sex, age, and duration of diabetes. Results: The prevalence of UW, OW, and obesity was: 1.4%, 22.3%, and 7.3% in males and 0.6%, 27.2%, and 6.8% in females. Adjusted BMI-SDS was significantly higher in females than in males (mean ± SEM: 0.54 ± 0.05 vs 0.40 ± 0.05, P < 0.0001). In males, BMI-SDS significantly decreased by age (P < 0.0001) in the first three age categories 0.61 ± 0.06 (2 to <10 years), 0.47 ± 0.06 (10 to <13 years), 0.34 ± 0.05 (13 to <16 years). In females, BMI-SDS showed a U-shaped distribution by age (P < 0.0001): 0.54 ± 0.04 (2 to <10 years), 0.39 ± 0.04 (10 to <13 years), 0.55 ± 0.04 (13 to <16 years). BMI-SDS increased by diabetes duration (<2 years: 0.38 ± 0.05, 2 to <5 years: 0.44 ± 0.05, and ≥5 years: 0.50 ± 0.05, P < 0.0001). Treatment modality did not affect BMI-SDS. Adjusted HbA1c was significantly higher in females than in males (8.20% ± 0.10% vs 8.06% ± 0.10%, P < 0.0001). In both genders, the association between HbA1c and BMI-SDS was U-shaped with the highest HbA1c in the UW and obesity groups. Conclusions: The high rate of OW and obesity (31.8%) emphasize the need for developing further strategies to prevent and treat excess fat accumulation in T1D.",

author = "Claudio Maffeis and Birkebaek, {Niels H} and Maia Konstantinova and Anke Schwandt and Andriani Vazeou and Kristina Casteels and Sujata Jali and Catarina Limbert and Auste Pundziute-Lycka and Peter Toth-Heyn and {de Beaufort}, Carine and Zdenek Sumnik and Valentino Cherubini and Jannet Svensson and Daniele Pacaud and Christina Kanaka-Gantenbein and Shlomit Shalitin and Natasa Bratina and Ragnar Hanas and Alonso, {Guy T} and Luxmi Poran and Pereira, {Ana L} and Marco Marigliano and {SWEET Study Group}",

note = "{\textcopyright} 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",

year = "2018",

month = nov,

doi = "10.1111/pedi.12730",

language = "English",

volume = "19",

pages = "1211--1220",

journal = "Pediatric Diabetes",

issn = "1399-543X",

publisher = "Wiley-Blackwell",

number = "7",

}

TY - JOUR

T1 - Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes

T2 - Data from the international SWEET registry

AU - Maffeis, Claudio

AU - Birkebaek, Niels H

AU - Konstantinova, Maia

AU - Schwandt, Anke

AU - Vazeou, Andriani

AU - Casteels, Kristina

AU - Jali, Sujata

AU - Limbert, Catarina

AU - Pundziute-Lycka, Auste

AU - Toth-Heyn, Peter

AU - de Beaufort, Carine

AU - Sumnik, Zdenek

AU - Cherubini, Valentino

AU - Svensson, Jannet

AU - Pacaud, Daniele

AU - Kanaka-Gantenbein, Christina

AU - Shalitin, Shlomit

AU - Bratina, Natasa

AU - Hanas, Ragnar

AU - Alonso, Guy T

AU - Poran, Luxmi

AU - Pereira, Ana L

AU - Marigliano, Marco

AU - SWEET Study Group

PY - 2018/11

Y1 - 2018/11

N2 - Objective: To assess the prevalence of underweight (UW), overweight (OW), and obesity in children and adolescents with type 1 diabetes (T1D). Methods: An international cross-sectional study including 23 026 T1D children (2-18 years, duration of diabetes ≥1 year) participating in the SWEET prospective, multicenter diabetes registry. Body mass index SD score (BMI-SDS) was calculated using the World Health Organization BMI charts. Children were categorized as UW (BMI-SDS < −2SD), OW (+1SD < BMI-SDS ≤ +2SD), and obese (OB) (BMI-SDS > +2SD). Hierarchic regression models were applied with adjustment for sex, age, and duration of diabetes. Results: The prevalence of UW, OW, and obesity was: 1.4%, 22.3%, and 7.3% in males and 0.6%, 27.2%, and 6.8% in females. Adjusted BMI-SDS was significantly higher in females than in males (mean ± SEM: 0.54 ± 0.05 vs 0.40 ± 0.05, P < 0.0001). In males, BMI-SDS significantly decreased by age (P < 0.0001) in the first three age categories 0.61 ± 0.06 (2 to <10 years), 0.47 ± 0.06 (10 to <13 years), 0.34 ± 0.05 (13 to <16 years). In females, BMI-SDS showed a U-shaped distribution by age (P < 0.0001): 0.54 ± 0.04 (2 to <10 years), 0.39 ± 0.04 (10 to <13 years), 0.55 ± 0.04 (13 to <16 years). BMI-SDS increased by diabetes duration (<2 years: 0.38 ± 0.05, 2 to <5 years: 0.44 ± 0.05, and ≥5 years: 0.50 ± 0.05, P < 0.0001). Treatment modality did not affect BMI-SDS. Adjusted HbA1c was significantly higher in females than in males (8.20% ± 0.10% vs 8.06% ± 0.10%, P < 0.0001). In both genders, the association between HbA1c and BMI-SDS was U-shaped with the highest HbA1c in the UW and obesity groups. Conclusions: The high rate of OW and obesity (31.8%) emphasize the need for developing further strategies to prevent and treat excess fat accumulation in T1D.

AB - Objective: To assess the prevalence of underweight (UW), overweight (OW), and obesity in children and adolescents with type 1 diabetes (T1D). Methods: An international cross-sectional study including 23 026 T1D children (2-18 years, duration of diabetes ≥1 year) participating in the SWEET prospective, multicenter diabetes registry. Body mass index SD score (BMI-SDS) was calculated using the World Health Organization BMI charts. Children were categorized as UW (BMI-SDS < −2SD), OW (+1SD < BMI-SDS ≤ +2SD), and obese (OB) (BMI-SDS > +2SD). Hierarchic regression models were applied with adjustment for sex, age, and duration of diabetes. Results: The prevalence of UW, OW, and obesity was: 1.4%, 22.3%, and 7.3% in males and 0.6%, 27.2%, and 6.8% in females. Adjusted BMI-SDS was significantly higher in females than in males (mean ± SEM: 0.54 ± 0.05 vs 0.40 ± 0.05, P < 0.0001). In males, BMI-SDS significantly decreased by age (P < 0.0001) in the first three age categories 0.61 ± 0.06 (2 to <10 years), 0.47 ± 0.06 (10 to <13 years), 0.34 ± 0.05 (13 to <16 years). In females, BMI-SDS showed a U-shaped distribution by age (P < 0.0001): 0.54 ± 0.04 (2 to <10 years), 0.39 ± 0.04 (10 to <13 years), 0.55 ± 0.04 (13 to <16 years). BMI-SDS increased by diabetes duration (<2 years: 0.38 ± 0.05, 2 to <5 years: 0.44 ± 0.05, and ≥5 years: 0.50 ± 0.05, P < 0.0001). Treatment modality did not affect BMI-SDS. Adjusted HbA1c was significantly higher in females than in males (8.20% ± 0.10% vs 8.06% ± 0.10%, P < 0.0001). In both genders, the association between HbA1c and BMI-SDS was U-shaped with the highest HbA1c in the UW and obesity groups. Conclusions: The high rate of OW and obesity (31.8%) emphasize the need for developing further strategies to prevent and treat excess fat accumulation in T1D.

U2 - 10.1111/pedi.12730

DO - 10.1111/pedi.12730

M3 - Journal article

C2 - 30033651

SN - 1399-543X

VL - 19

SP - 1211

EP - 1220

JO - Pediatric Diabetes

JF - Pediatric Diabetes

IS - 7

ER -

Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry

Abstract

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