Body Mass Index and Incident Type 1 and Type 2 Diabetes in Children and Young Adults: A Retrospective Cohort Study

Abstract

Context:Little is known about the association between obesity and temporal trends in the incidence of diabetes in children and young adults.Objective:We examined the recent incidence of types 1 and 2 diabetes in relation to a high body mass index (BMI) in UK children and young adults.Design:Cohort and nested case-control.Setting:A total of 375 general practices that contribute to the UK Clinical Practice Research Datalink (CPRD).Participants:A total of 369,362 participants aged 2 to 15 years at BMI measurement in CPRD from 1994 to 2013.Intervention:None.Main outcome measures:Incident type 1 diabetes (T1D) and type 2 diabetes (T2D) diagnoses up to age 25 years.Results:A total of 654 incident cases of T2D and 1318 T1D cases were found. The incidence of T2D per 100,000 persons annually increased from 6.4 in 1994 to 1998 to 33.2 in 2009 to 2013; and that for T1D increased from 38.2 to 52.1 per 100,000 persons during the same period. The incidence of T2D increased in both overweight (85th to 95th percentile for age- and sex-specific BMI; P = 0.01) and obese (≥95th percentile; P < 0.01) individuals from 1994 to 2013. Obese individuals, who constituted 47.1% of T2D cases, had a markedly greater risk of incident T2D [odds ratio, 3.75; 95% confidence interval (CI), 3.07 to 4.57], with an incidence rate ratio of 4.33 (95% CI, 3.68 to 5.08) compared with the normal BMI category. No positive linear association was found between obesity (greater BMI) and incident T1D cases.Conclusions:Increasing obesity has contributed to the increasing incidence of T2D but not T1D among UK children and young adults, with a fourfold greater risk of developing T2D in obese individuals.

Obesity and ageing: Two sides of the same coin

“…In the United States, close to one in three adults over the age of 65 years have T2DM. Ninety percent of people with T2DM have overweight or obesity, and the presence of obesity accelerates the development of T2DM . Children with T2DM were rarely reported in the 1980s .…”

“…As the incidence of obesity in children climbed over the past 30 years, so too did the prevalence of T2DM . It is estimated that, compared to those with a normal BMI, the incidence of T2DM is four times higher in children with obesity . Moreover, BMI changes the lifetime risk of T2DM.…”

Sugar-Sweetened Beverage, Obesity, and Type 2 Diabetes in Children and Adolescents: Policies, Taxation, and Programs

“…Obese children are more likely to become obese adults [17], further increasing their risks for higher rates of T2DM, heart diseases, and some cancers later in life. A recent large cohort study found that a child with obesity faces a 4-fold greater risk of being diagnosed with T2DM by age 25 than a counterpart who is normal weight [18•]. Another well-powered meta-analysis also found that individuals in the highest quantile of SSB intake (most often 1 −2 servings/day) had a 26% greater risk of developing T2DM than those in the lowest quantile (none or < 1 serving/month).…”

Youth-Onset Type 2 Diabetes Manifestations in other Specialties: Its Many Disguises

“…Table S2) [1,15]. Although obesity is one of the metabolic syndrome parameters, its link with youth-onset T2D has been investigated separately (e.g., [16,17]). Children and adolescents from the United Kingdom who were within the obesity category had a 4.3 greater risk of T2D compared with their normal-weight peers [16].…”

“…Although obesity is one of the metabolic syndrome parameters, its link with youth-onset T2D has been investigated separately (e.g., [16,17]). Children and adolescents from the United Kingdom who were within the obesity category had a 4.3 greater risk of T2D compared with their normal-weight peers [16]. A similar increased risk for children with obesity was also found in a prospective study of American Indians, where the relative risk of developing T2D ranged from 2.3 to 7.4, depending on gender, age, and degree of overweight [17].…”