Secular trends in BMI in a cohort of children with Type 1 diabetes in the first-year post diagnosis

Abstract

Background: Along with the global increase in the rates of overweight and obesity in the pediatric population, it is becoming more prevalent in children with type 1 diabetes. The presence of diabetes and obesity may further aggravate the long term outcome of these children. Aims: Evaluate the secular change in BMI in children during the first year after the diagnosis of type 1 diabetes and identify variables affecting this change. Methods: This is a retrospective cohort study conducted at the diabetes clinic at Shaare Zedek Medical Center. Demographic data was withdrawn from the patients' charts and included age, age at diagnosis, gender and ethnic origin. Clinical data included DKA at diagnosis, height, weight, and BMI at presentation and throughout the first year following diagnosis at several pre-determined time points. Results: The study included 167 patients, 93 males. The average BMI- Z at presentation was -0.65 and increased to 0.35 after a year from diagnosis. The most pronounced increase in BMIZ occurred as expected in the first month (0.5-0.75), but it continued during the first year. At diagnosis, 16.6% of the children were underweight, 11.8% overweight and 2.7% obese. By the end of the first year, there were more overweight 28.5%, and obese 6.3% children. The lower the BMI-Z at diagnosis, the greater the weight gain observed at all-time points throughout the year. DKA at presentation was associated with a more significant weight gain in the first year using univariate analysis. No correlation was found between the patients' gender or age at diagnosis and the degree of weight gain. Conclusions: Continuous weight gain was observed throughout the first year after the diagnosis of diabetes, with a significant increase in the rate of overweight and obesity.