title: Associations of youth and parent weight status with reported versus predicted daily energy intake and hemoglobin A1c in youth with type 1 diabetes mellitus.
abstract: BACKGROUND
  The epidemic of overweight/obesity affects youth with type 1 diabetes mellitus (T1DM) and their families. In youth with T1DM and their parents, we examined weight status with reported and expected energy intake and with youth hemoglobin A1c (HbA1c).
  
  
  METHODS
  In 243 youth (48% female, 13 ± 3 years) and their parents (84% female, 45 ± 6 years), we assessed body mass index (BMI), prevalence of overweight/obesity, reported energy intake (REI), and youth glycemic control (HbA1c). The REI was compared with predicted daily energy requirements (DER; based on age, weight, sex, and physical activity).
  
  
  RESULTS
  Youth had diabetes duration of 6.3 ± 3.4 years and HbA1c of 8.5% ± 1.3%; 69% used insulin pump therapy. Overweight and obesity affected 23% and 11% of youth and 30% and 24% of parents, respectively. Youth and parent BMI (r = 0.38; p < .001) and weight status (overweight/obese; p < .001) were significantly associated. The ratio of REI:DER was significantly lower in overweight/obese compared with underweight/normal weight parents (1.0 ± 0.4 versus 1.2 ± 0.5; p = .001) but did not differ among youth by weight status. Both youth and parent BMI were positively correlated with youth HbA1c (r = 0.14, p = .02; r = 0.16, p = .01, respectively). Hemoglobin A1c tended to be higher in obese than in overweight and normal weight youth (mean ± standard deviation [SD] 8.4 ± 1.4, 8.4 ± 1.3, and 8.8 ± 1.0, respectively; p = .06) and was significantly higher in youth whose parents were obese versus overweight or underweight/normal weight (mean ± SD 8.2 ± 1.2, 8.5 ± 1.4, and 8.9 ± 1.5, respectively; p < .001).
  
  
  CONCLUSIONS
  Similar to the general population, overweight and obesity are prevalent among families of youth with T1DM. Weight status appears to influence self-REI in parents and glycemic control in youth with T1DM, suggesting the need for family-based dietary interventions.
authors: Pediatric, Adolescent, and Young Adult Section, Genetics and Epidemiology Section, Joslin Diabetes Center, Boston, Massachusetts; 02215, USA.
authors: Amanda L P
authors: AL
authors: Sands
authors: Laurie A
authors: LA
authors: Higgins
authors: Sanjeev N
authors: SN
authors: Mehta
authors: Tonja R
authors: TR
authors: Nansel
authors: Leah M
authors: LM
authors: Lipsky
authors: Lori M B
authors: LM
authors: Laffel
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D002149:Energy Intake; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D050177:Overweight / Q000150:complications* / Q000453:epidemiology*; D010290:Parents; D015995:Prevalence
chemical_list: D006442:Glycated Hemoglobin