Temporal patterns in overweight and obesity in Type 1 diabetes.
OBJECTIVE
Time trends in overweight and obesity in the general population have been well documented; however, temporal patterns in Type 1 diabetes (T1DM) have not been thoroughly investigated. We therefore assessed temporal patterns in overweight and obesity and predictors of weight change in 589 individuals from the Pittsburgh Epidemiology of Diabetes Complications Study, a cohort of childhood-onset T1DM.


METHODS
Participants were first seen in 1986-1988, when mean age and diabetes duration were 29 and 20 years, respectively, and biennially thereafter for 18 years. Overweight was defined as 25.0<or=body mass index (BMI)<30.0 kg/m2. Obesity was defined as BMI>or=30.0 kg/m2.


RESULTS
At baseline, the prevalence of overweight and obesity were 28.6% and 3.4%, respectively. After 18 years' follow-up, the prevalence of overweight increased by 47% while the prevalence of obesity increased sevenfold. Seven per cent were on intensive insulin therapy (>or=3 insulin injections per day or on insulin pump) at baseline; by 2004-2007, this was 82%. Predictors of weight change were a higher baseline HbA1c, symptomatic autonomic neuropathy (inversely), overt nephropathy (inversely), and going onto intensive insulin therapy during follow-up.


CONCLUSIONS
These data demonstrate dramatic weight gain in T1DM and underscore the complexity of weight change in this disease.
Division of Epidemiology, Vanderbilt University, Nashville, TN, USA.
B
B
Conway
R G
RG
Miller
T
T
Costacou
L
L
Fried
S
S
Kelsey
R W
RW
Evans
T J
TJ
Orchard
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D050177:Overweight / Q000150:complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D015430:Weight Gain; D055815:Young Adult
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin