Overweight and obesity in type 1 diabetes equal those of the general population

Abstract

Summary Background The obesity epidemic might affect patients with type 1 diabetes (T1DM), historically described as lean and insulin-sensitive subjects. Insulin resistance in T1DM might increase diabetic complications, especially cardiovascular disease. Therefore, the body mass index (BMI) in T1DM patients was analyzed in comparison to the general population. Furthermore, the impact of increased BMI on glycemic control and metabolic alterations was assessed. Methods Body mass index was compared overall and among four different age groups between adult T1DM ( n = 186), treated in the outpatient clinic between 2014 and 2016, and 15,771 individuals from the general population who took part at an Austrian health survey. Furthermore, parameters of glycemic control, lipid state, blood pressure and additional medication were compared between T1DM with a BMI under or above 27.5 kg/m 2 . Results Patients with T1DM had significantly higher BMI values than general population (25.9 ± 4.2 kg/m 2 vs. 25.3 ± 4.5 kg/m 2 ; p = 0.027), controlling for age group; however, prevalence of overweight (39.8% vs. 33.1%) and obesity (14% vs. 13.8%) was not significantly different. Within the 4 age groups only T1DM patients between 30 years and 49 years old had significantly higher BMI values compared to the general population (mean difference 1.9 kg/m 2 ; 95% confidence interval, CI: 0.96–2.83 kg/m 2 ). In T1DM, a BMI ≥27.5 kg/m 2 was associated with increased rates of hypertension, dyslipidemia, microalbuminuria, and increased insulin demand, whereas glycemic control was not affected. Conclusions In contrast to common descriptions T1DM patients have a higher BMI compared to the general population. Rates of overweight and obesity in T1DM equal those of the general population. Therefore, it is concluded that the obesity epidemic has reached T1DM patients and “double diabetes” might be an entity to consider.

Efficacy and safety of adding sotagliflozin, a dual sodium‐glucose co‐transporter (SGLT)1 and SGLT2 inhibitor, to optimized insulin therapy in adults with type 1 diabetes and baseline body mass index ≥ 27 kg/m2

“…Overweight adults with T1D and inadequate glycaemic control comprise a population with an unmet medical need. Intensified insulin reduces the incidence and progression of long‐term diabetes‐related complications but is also associated with risks of hypoglycaemia and undesirable weight gain, which in turn are associated with increased cardiovascular risk 1,3 . Therefore, in addition to lowering blood glucose, reducing body weight and systolic blood pressure are of great importance in patients with higher BMI 1 …”

“…Up to 50% of adults living with type 1 diabetes (T1D) are overweight or obese 1,2 . Excess weight is associated with a high frequency of other cardiovascular risk factors 1,3 .…”

Clinical and Demographic Features among Patients with Type 1 Diabetes Mellitus in Henan, China

“…There are many studies that reported the prevalence of overweight and obesity of T1D, which varies from 21-53.8% in different countries [24,[26][27][28]. The current study of children, adolescents and adults showed that the prevalence of being overweight or obesity was 16.9%.…”

Relationship Between Microalbuminuria and 24-hour Blood Pressure Monitoring in Patients with Type 1 Diabetes

“…Tedavi alan hastaların büyük bir kısmının diyete uyum sürecini aksattıkları dönemlerde tekrarlayan medikal tedavi ihtiyaçları olduğu görülmüştür (15,16). Yapılan çalışmalarda obezite ile mikroalbuminüri arasında ilişki bulunurken mikroalbuminürisi olan 56 hastamızın sadece 7 si obezdi(p>0.05) (10,17). Hasta popülasyonumuzun genellikle sosyoekonomik ve sosyokültürel olarak dar gelirli ailelerden oluştuğunu varsayarsak bu oranın düşüklüğünü beslenme yetersizliği ile açıklayabiliriz.…”