title: Is the change in body mass index among children newly diagnosed with type 1 diabetes mellitus associated with obesity at transition from pediatric to adult care?
abstract: Insulin therapy is lifesaving treatment for individuals with type 1 diabetes (T1D). Its initiation maybe associated with significant weight gain because of change from a catabolic to an anabolic state. Excessive weight-gain increases the risk of obesity and is associated with chronic disease.
  
  
  
  To examine if change in body mass index (BMI) among children in the 6 months after diagnosis with type 1 diabetes mellitus is associated with long-term obesity.
  
  
  
  This was a population-based retrospective study of 377 children (aged 2-18 yr) with type 1 diabetes. Measured heights and weights were used to calculate BMI z-scores based on Centers for Disease Control and Prevention (CDC) cut-points. Generalized Linear Models using BMI group, and age group at diagnosis; postdiagnosis weight change; and sex were applied to assess associations between postdiagnosis weight change and BMI z-score at transition to adult care.
  
  
  
  Mean BMI z-score increased from 0.28 at diagnosis, to 0.53 at 6 months and 0.66 at transition to adult care. Change in BMI z-scores differed by initial BMI group and magnitude of postdiagnosis weight change. Younger children (<11 yr) had higher (p = 0.004) BMI z-scores at diagnosis but not at last visit (p = 0.1) than older (≥11 yr) children at diagnosis. BMI z-score at diagnosis, postdiagnosis weight change, female sex, and longer duration with TID were associated with higher BMI z-score at time of transition.
  
  
  
  BMI z-score at diagnosis was the strongest predictor of BMI z-score at time of transition to adult care, however; its effect was mediated by magnitude of weight change 6 months after diagnosis, sex, and age group at diagnosis.
authors.affiliation: School of Human Kinetics, University of Ottawa, Faculty of Health Sciences, Ottawa, ON, Canada. tmanyanga@cheo.on.ca.|Children's Hospital of Eastern Ontario Research Institute, Healthy Active Living and Obesity Research Group, Ottawa, ON, Canada. tmanyanga@cheo.on.ca.
authors.forename: Taru
authors.initials: T
authors.lastname: Manyanga
authors.affiliation: Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.|Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada.
authors.forename: Elizabeth Ac
authors.initials: EA
authors.lastname: Sellers
authors.affiliation: Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.|Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada.
authors.forename: Brandy A
authors.initials: BA
authors.lastname: Wicklow
authors.affiliation: Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Doupe
authors.affiliation: Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.
authors.forename: Randall
authors.initials: R
authors.lastname: Fransoo
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D006801:Humans; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D060305:Transition to Adult Care / Q000706:statistics & numerical data; D015430:Weight Gain / Q000502:physiology*; D055815:Young Adult
keywords: BMI z-score; child obesity; insulin therapy; type 1 diabetes