Overweight and obese children with optimal control in the T1D Exchange Registry: How are they different from lean children with optimal control?.

MedStar author(s):
Citation: Journal of Diabetes & its Complications. 34(4):107513, 2020 04.PMID: 32007420Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, N.I.H., ExtramuralSubject headings: *Diabetes Mellitus, Type 1/ep [Epidemiology] | *Glycemic Control/sn [Statistics & Numerical Data] | *Overweight/ep [Epidemiology] | *Pediatric Obesity/ep [Epidemiology] | Adolescent | Blood Glucose Self-Monitoring | Blood Glucose/me [Metabolism] | Child | Child, Preschool | Cohort Studies | Diabetes Mellitus, Type 1/bl [Blood] | Diabetes Mellitus, Type 1/co [Complications] | Female | Glycated Hemoglobin A/me [Metabolism] | Glycemic Control/st [Standards] | Humans | Infant | Infant, Newborn | Insulin Infusion Systems | Insulin/ad [Administration & Dosage] | Male | Overweight/bl [Blood] | Overweight/co [Complications] | Pediatric Obesity/bl [Blood] | Pediatric Obesity/co [Complications] | Registries/sn [Statistics & Numerical Data] | United States/ep [Epidemiology] | Young AdultYear: 2020ISSN:
  • 1056-8727
Name of journal: Journal of diabetes and its complicationsAbstract: AIMS: Increased adiposity is a risk factor for suboptimal diabetes control and cardiovascular disease (CVD) complications. Our goal was to identify modifiable behavioral characteristics of overweight and obese pediatric patients with type 1 diabetes mellitus (T1DM) who achieve optimal glycemic control and to evaluate their CVD risk compared to lean patients. Our hypothesis was that optimally controlled obese and overweight participants require more total daily insulin and are at higher CVD risk compared to optimally controlled lean participants.CONCLUSIONS: There were no differences in modifiable behavioral characteristics between the obese, overweight and lean optimally controlled participants. However, predictors of cardiovascular disease were higher in the overweight and obese group. Copyright (c) 2019 Elsevier Inc. All rights reserved.METHODS: We analyzed a cohort of 9263 participants with T1DM aged <21years in the T1D Exchange Registry. Optimal diabetes control was defined as HbA1c<=7.5% (58mmol/mol). We compared factors that influence glycemic control in lean, overweight and obese participants with optimal vs. suboptimal control, using logistic regression.RESULTS: Age, race, overweight status, continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) use were important variables influencing glycemic control. In the optimally controlled cohort, 27% of participants were overweight or obese versus 30% in the suboptimally controlled cohort (P<0.001). Overweight and obese participants with optimal control were not significantly different from lean participants in terms of CSII use, total daily insulin dosage per kg of bodyweight, glucose checks per day, boluses with bedtime snack, use of CGM, but had higher LDL cholesterol and triglycerides, and lower HDL cholesterol (P<0.05).All authors: Anhalt H, Flokas ME, Gourgari E, Mete M, Rother KI, Zeymo AOriginally published: Journal of Diabetes & its Complications. 34(4):107513, 2020 04.Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2020-02-10
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Journal Article MedStar Authors Catalog Article 32007420 Available 32007420

AIMS: Increased adiposity is a risk factor for suboptimal diabetes control and cardiovascular disease (CVD) complications. Our goal was to identify modifiable behavioral characteristics of overweight and obese pediatric patients with type 1 diabetes mellitus (T1DM) who achieve optimal glycemic control and to evaluate their CVD risk compared to lean patients. Our hypothesis was that optimally controlled obese and overweight participants require more total daily insulin and are at higher CVD risk compared to optimally controlled lean participants.

CONCLUSIONS: There were no differences in modifiable behavioral characteristics between the obese, overweight and lean optimally controlled participants. However, predictors of cardiovascular disease were higher in the overweight and obese group. Copyright (c) 2019 Elsevier Inc. All rights reserved.

METHODS: We analyzed a cohort of 9263 participants with T1DM aged <21years in the T1D Exchange Registry. Optimal diabetes control was defined as HbA1c<=7.5% (58mmol/mol). We compared factors that influence glycemic control in lean, overweight and obese participants with optimal vs. suboptimal control, using logistic regression.

RESULTS: Age, race, overweight status, continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) use were important variables influencing glycemic control. In the optimally controlled cohort, 27% of participants were overweight or obese versus 30% in the suboptimally controlled cohort (P<0.001). Overweight and obese participants with optimal control were not significantly different from lean participants in terms of CSII use, total daily insulin dosage per kg of bodyweight, glucose checks per day, boluses with bedtime snack, use of CGM, but had higher LDL cholesterol and triglycerides, and lower HDL cholesterol (P<0.05).

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