Effect of low-dose insulin treatment on body weight and physical development in children and adolescents at risk for type 1 diabetes.
OBJECTIVE
Insulin's role in body weight regulation is controversial. We evaluated the effect of parenteral insulin on body weight and physical development in children and adolescents at risk for type 1 diabetes.


METHODS
We performed a secondary analysis of the parenteral arm of the Diabetes Prevention Trial-Type 1 Diabetes (DPT-1), a randomized controlled trial of low-dose parenteral insulin (human ultralente insulin at 0.25 units x kg(-1) x day(-1)) in subjects with a >50% 5-year risk of diabetes. Analysis was limited to 100 subjects (55 intervention, 45 closely monitored) aged <19 years at randomization whose weight was followed for at least 2 years by study end after excluding subjects who were noncompliant within 2 years or developed diabetes within 36 months of randomization.


RESULTS
Subjects ranged in age from 4.07 to 18.98 years. There were no significant differences at randomization between subjects in each group with respect to sex, age, weight, height, BMI, Tanner stage, or glucose tolerance. We found no differences over 2 years between the intervention and closely monitored groups in the change in weight (median 6.8 vs. 6.0 kg, P = 0.65), height (median 10.7 vs. 10.1 cm, P = 0.66), BMI (median 0.9 vs. 1.0 kg/m2, P = 0.79), or Tanner stage (median 0 vs. 0, P = 0.35). Multiple regression showed no effect of insulin on change in weight (P = 0.53) or BMI (P = 0.95) over 2 years after adjustment for relevant covariates.


CONCLUSIONS
Low-dose insulin treatment for 2 years did not affect the weight, BMI, or physical development of nondiabetic children and adolescents.
Rhodes
Erinn T
ET
Division of Endocrinology, Children's Hospital Boston, 300 Longwood Ave., Boston, MA 02115, USA.
Wolfsdorf
Joseph I
JI
Cuthbertson
David D
DD
Feldman
Henry A
HA
Ludwig
David S
DS
D000293:Adolescent; D001835:Body Weight; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000517:prevention & control*; D005260:Female; D018149:Glucose Intolerance / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D049528:Insulin, Long-Acting / Q000627:therapeutic use*; D008297:Male; D012307:Risk Factors; D012727:Sex Characteristics
D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting