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Certain kids with diabetes are most at risk for excess weight: study

By Allison Bond MD

NEW YORK (Reuters Health) - Children and teens with type 1 diabetes are already at increased risk for becoming overweight or obese, but certain traits make the odds even higher, according to a new study.

Because obesity can compound some of the health problems that go along with diabetes, it’s important to help kids avoid weight gain, researchers say.

Elke Frohlich-Reiterer, of Medical University Graz in Austria, and her colleagues analyzed data collected from 250 diabetes centers in Germany and Austria; altogether, there were 12,774 participants in the study.

All the kids were under the age of 20 and had type 1 diabetes, which used to be known as juvenile diabetes because it typically appears during childhood.

In type 1 diabetes, the body’s immune system destroys the cells of the pancreas that normally produce the insulin necessary for processing sugars in food. The other variety - type 2 diabetes - occurs when the body doesn’t properly use insulin.

The children in the study were grouped by age: under five years, 5-10 years, 10-15 years and 15-20 years. They were also divided into categories based on how long they had had diabetes: less than two years, 2-5 years, 5-10 years and more than 10 years.

The researchers found that being female, a younger age when diabetes was first diagnosed and having diabetes for a longer time were all linked to a bigger jump in body mass index, a measure of weight relative to height and peer group.

Using short-acting insulin medicines was also linked to greater weight gain in girls, whereas using long-acting insulin was linked to more weight gain in boys.

Finally, girls who developed diabetes around the time they went through puberty - between the ages of 10 and 15 years old - were more likely to have gained excess weight.

“The increasing prevalence of overweight and obesity and associated risk factors among youth are major global health problems,” the authors write in the paper, which was published in the journal Archives of Disease in Childhood.

“As children and adolescents with type 1 diabetes are also at increased risk to develop overweight and obesity, weight gain is an important aspect in the care of children and adolescents with (the disease),” making it important to figure out which factors indicate a higher risk of this excess weight gain, they write.

The study reinforces what’s already known about young people with diabetes, who are at an increased risk of excess weight gain as they grow up, a researcher not involved in the study said.

But the new work also “provides additional insight into important factors for the development of obesity,” said Karen Peterson, a researcher in nutrition at the University of Michigan in Ann Arbor.

Weight gain among people with diabetes is especially detrimental because the risks of diabetes and obesity overlap and can be additive, she said.

“Higher weights can exacerbate the insulin resistance that comes with diabetes. And obesity has some of the same metabolic issues diabetes does, such as adding to risk factors (for heart disease),” Peterson told Reuters Health.

That’s why it’s particularly important for kids with diabetes to maintain healthy habits, keeping in mind that some weight gain during childhood and adolescence is normal and healthy.

Peterson recommends that parents track their child’s pattern of weight gain, but instead of focusing on weight, “emphasize an overall healthy diet that includes more fruits, veggies, and complex carbohydrates, and which is coupled with active play,” she said.

SOURCE: http://bit.ly/1tuZ9Dh Archives of Disease in Childhood, online May 8, 2014.

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