Clinical, Psychosocial, and Demographic Factors Are Associated With Overweight and Obesity in Early Adolescent Girls With Type 1 Diabetes

Abstract

Purpose-The purpose of the study was to examine the differences in clinical, psychosocial, and demographic factors by sex and weight status.Methods-Baseline data were analyzed from 318 adolescents (mean age = 12.3 ± 1.1 years, 55.0% female, 62.7% white) with type 1 diabetes (T1D) from a multisite clinical trial. Differences were examined between normal weight (body mass index ≥5th and <85th percentile) and overweight/obese (body mass index ≥85th percentile) boys and girls with T1D in clinical, psychosocial, and demographic factors. Descriptive and multiple logistic regression analyses were used.Results-Overweight/obesity was prevalent (39.0%) and common in girls (42.6%) and boys (33.1%). In bivariate analyses, overweight/obese girls had parents with lower educational attainment, longer diabetes duration, and significantly worse self-management and psychosocial health as compared with normal weight girls. There were no differences between overweight/ obese and normal weight girls in A1C, therapy type, race/ethnicity, or household income. No significant differences were found between normal weight and overweight/obese boys. In For reprints and permission queries, please visit SAGE's Web site at http://www.sagepub.com/journalsPermissions.nav. Correspondence to Karl E. Minges, Yale University School of Nursing, 400 West Campus Drive, Orange, CT 06477, USA (karl.minges@yale.edu). HHS Public Access Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript multivariate analysis, parental educational attainment (master or higher vs high school diploma or less) and perceived stress were significantly associated with overweight/ obesity in girls. Longer duration of T1D bordered statistical significance.Conclusions-Overweight/obesity is prevalent among adolescents with T1D. Clinical, psychosocial, and demographic factors are associated with overweight/obesity in girls but not boys. Greater attention to weight status and aspects of health that are germane to adolescents with T1D is warranted.Overweight and obesity (body mass index [BMI] ≥85th percentile) in adolescents with type 1 diabetes (T1D) has become an important clinical and public health concern. 1 The prevalence of overweight and obesity in adolescents with T1D now mirror that of the general population of adolescents, approximately 39%, and the rate of overweight and obesity among adolescents with T1D has more than tripled over the past few decades. [1][2][3] Youth with T1D have a higher prevalence of overweight (22% vs 16%) but not obesity (13% vs 17%) than do their peers without diabetes, 4 and girls with T1D have a higher prevalence of overweight than do boys with T1D. 5,6 Reasons for these rates of overweight and obesity in adolescents with T1D are unclear but may be related to the concomitant increase in the use of intensive insulin regimens, gene-environment interactions, and/or lifestyle factors. [7][8][9] Overweight/obesity and the associated cardiometabolic risk factors in adolescents with T1D account for significant cardiovascular co...

Biopsychosocial Aspects of Weight Management in Type 1 Diabetes: a Review and Next Steps

“…The T1D Exchange recently documented that 36% of adolescents with T1D are overweight/obese [20, 21••], which is consistent with the SEARCH for Diabetes in Youth Study [22] and other US T1D samples [23, 24] but higher than the general population [25]. In addition, Canadian and Polish studies of children and adolescents with T1D found that 35 and 30%, respectively, were overweight/obese [26, 27].…”

“…Many studies have shown that girls and women with T1D are more likely to be overweight and/or obese than are boys and men [21••, 24, 27, 28]. However, Duca and colleagues recently reported that 68 and 59% of men and women were in the overweight/obese weight categories, respectively, with more men classified as obese and more women as overweight [29].…”

Correlates of overweight and obesity in 5529 adolescents with type 1 diabetes: The T1D Exchange Clinic Registry

“…Moreover, these factors may differentially impact adolescents, as these youth may also encounter issues related to identity, social norms, and gaining independence, which have been found to be related to challenges with diabetes self-management. [24–27] Several of these factors have been associated with overweight/obesity among adolescents in the general population, but findings are limited among adolescents with T1D. [4]…”

Understanding antagonism and synergism: A qualitative assessment of weight management in youth with Type 1 diabetes mellitus

“…Across focus groups, the thematic content and emphasis varied significantly across sex, evidencing the existence of differences in the psychosocial aspects of both weight management (Kaminsky and Dewey, 2014; Minges et al, 2016) and T1DM (Huxley et al, 2015; Powers et al, 2017). The largest sex difference emerged with regard to several weight attitudes and behaviors reported uniquely by females.…”