Original ArticleOverweight Is Highly Prevalent In Children with Type 1 Diabetes And Associates with Cardiometabolic Risk
Section snippets
Methods
We studied a cohort of consecutive children (age 3 to 18 years) with T1DM who attended a Dutch specialized Pediatric Diabetes Center in Rotterdam in the period 2007 to 2008. Data were collected according to a standardized treatment protocol and cross-sectional analyses were performed to assess cardiometabolic risk factors within this cohort.
T1DM was diagnosed according to criteria of the American Diabetes Association (ADA), including measurements of autoantibodies (islet cell antibodies [ICA],
Results
The baseline characteristics are shown in Table I. The majority (77.0%) of children was Dutch native 3.5% was Turkish and 7.1% Moroccan. The remaining group (12.4%) consisted of children with other ethnic backgrounds or children of parents with 2 different origins. In the present cohort, 38.5% of the children were classified as overweight/obese, and 9.2% were obese (Z-BMI ≥2 ). Overweight/obese children differed with respect to their normal-weight counterparts for age, diabetes duration, age of
Discussion
In our study, the proportion of obese children with T1DM (Z-BMI ≥2) was twice as high as recently described in a comparable Norwegian cohort, whereas the prevalence of BMI >90th percentile was similar to that found in a German pediatric T1DM cohort.9, 10 In a multi-ethnic cohort with diabetes (mainly type 1) in the United States, the proportion of obese children (as determined by high waist circumference) ranged from 15% of non-Hispanic white children, to 56% in Native American children.23
The
References (46)
- et al.
Prevalence and prognostic implications of the metabolic syndrome in community-based patients with type 1 diabetes: the Fremantle Diabetes Study
Diabetes Res Clin Pract
(2007) - et al.
The metabolic syndrome in type 1 diabetes: does it exist and does it matter?
J Diabetes Complications
(2008) - et al.
Relationship between autonomic dysfunction, insulin resistance and hypertension, in diabetes
Nutr Metab Cardiovasc Dis
(2005) - et al.
Lipid abnormalities are prevalent in youth with type 1 and type 2 diabetes: the SEARCH for Diabetes in Youth Study
J Pediatr
(2006) Health consequences of obesity in youth: childhood predictors of adult disease
Pediatrics
(1998)- et al.
Relationship of family history of type 2 diabetes, hypoglycemia, and autoantibodies to weight gain and lipids with intensive and conventional therapy in the Diabetes Control and Complications Trial
Diabetes
(2003) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus: the Diabetes Control and Complications Trial Research Group
N Engl J Med
(1993)- et al.
Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes
N Engl J Med
(2005) Influence of intensive diabetes treatment on body weight and composition of adults with type 1 diabetes in the Diabetes Control and Complications Trial
Diabetes Care
(2001)- et al.
High risk of cardiovascular disease in patients with type 1 diabetes in the UK: a cohort study using the general practice research database
Diabetes Care
(2006)
Childhood risk factors predict adult risk associated with subclinical cardiovascular disease: the Bogalusa Heart Study
Am J Cardiol
Increased aortic intima-media thickness: a marker of preclinical atherosclerosis in high-risk children
Circulation
High prevalence of cardiovascular risk factors in children and adolescents with type 1 diabetes: a population-based study
Diabetologia
Spectrum and prevalence of atherogenic risk factors in 27,358 children, adolescents, and young adults with type 1 diabetes: cross-sectional data from the German diabetes documentation and quality management system (DPV)
Diabetes Care
Prognostic impact of metabolic syndrome by different definitions in a population with high prevalence of obesity and diabetes: the Strong Heart Study
Diabetes Care
Metabolic syndrome in childhood predicts adult cardiovascular disease 25 years later: the Princeton Lipid Research Clinics Follow-up Study
Pediatrics
Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association
Diabetes Care
Utility of the modified ATP III defined metabolic syndrome and severe obesity as predictors of insulin resistance in overweight children and adolescents: a cross-sectional study
Cardiovasc Diabetol
Standards of medical care in diabetes–2006
Diabetes Care
Body index measurements in 1996-7 compared with 1980
Arch Dis Child
Are age references for waist circumference, hip circumference and waist-hip ratio in Dutch children useful in clinical practice?
Eur J Pediatr
Blood pressure in childhood: pooled findings of six European studies
J Hypertens
ISPAD clinical practice consensus guidelines 2006-2007 microvascular and macrovascular complications
Pediatr Diabetes
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The authors declare no conflicts of interest.
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Both authors contributed equally to this article.