Change in glycemic control predicts change in weight in adolescent boys with type 1 diabetes.
OBJECTIVE
To characterize the intraindividual relationships between changes in weight, glycosylated hemoglobin (HbA1c) levels, and reported total daily insulin dose between clinic visits in adolescent boys with type 1 diabetes (T1D).


METHODS
Intraindividual changes in HbA1c, anthropometric data, and reported total daily insulin dose between consecutive visits for 94 adolescent boys with T1D were analyzed.


RESULTS
Average quarterly weight gain was 2.8 kg during periods of improving, 1.5 kg during periods of minimal change, and 0.8 kg during periods of worsening glycemic control (improving vs. minimal change p < 0.001; minimal change vs. worsening p = 0.11; improving vs. worsening p < 0.001). Analyzing the quarterly weight velocity according to change in reported total daily dose of insulin, we found significantly greater weight gain during intervals when the family reported a decreasing insulin dose compared to intervals when the family reported no change in insulin dose (p = 0.003). Conversely, weight change during periods of reported increasing insulin dose was similar to that when the family reported that the boy's insulin dose did not change.


CONCLUSIONS
Quarterly weight velocity was correlated with degree of change in glycemic control between visits in adolescent boys with T1D. When weight loss or inadequate weight gain and worsening glycemic control occur, the possibility of insulin omission must be explored. Reviewing the adolescent's growth data and then the division of responsibilities for diabetes management within the family, clinicians must reconcile discrepancies between weight velocity and a reportedly adequate dose of insulin.
Quinn
Maryanne
M
Division of Endocrinology, Children's Hospital Boston, Boston, MA 02115, USA. maryanne.quinn@tch.harvard.edu
Ficociello
Linda H
LH
Rosner
Bernard
B
D000293:Adolescent; D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight / Q000502:physiology*; D002165:Camping; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D004305:Dose-Response Relationship, Drug; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008404:Massachusetts; D008499:Medical Records; D011237:Predictive Value of Tests; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin