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Published in: BMC Pediatrics 1/2022

Open Access 01-12-2022 | Obesity | Research

Changes from 1986 to 2018 in the prevalence of obesity and overweight, metabolic control and treatment in children with type 1 diabetes mellitus in a Mediterranean area of Southeast Spain

Authors: María Teresa Pastor-Fajardo, María Teresa Fajardo-Giménez, Vicente María Bosch-Giménez, José Pastor-Rosado

Published in: BMC Pediatrics | Issue 1/2022

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Abstract

Background

In recent decades, a global increase in the prevalence of childhood overweight and obesity has been observed in children and adolescents with type 1 diabetes.

Methods

This retrospective, cross-sectional, population study examined three groups (1986, 2007, and 2018) of children and adolescents aged < 16 years diagnosed with type 1 diabetes. Overweight and obesity were defined according to the World Health Organization recommendations.

Results

The prevalence of overweight and obesity in diabetic children and adolescents was 30.2% (95% CI: 23.1–38.3). There was a significant increase from 1986 to 2007 (11.9% to 41.7%, p = 0.002) and from 1986 to 2018 (11.9% to 34.8%, p = 0.012), but no significant differences were found from 2007 to 2018 (41.7% to 34.8%, p = 0.492). The age at diagnosis was lower in the group with excess body mass (p = 0.037). No significant differences were observed in age (p = 0.690), duration of diabetes (p = 0.163), distribution according to sex (p = 0.452), metabolic control (HbA1c, p = 0.909), or insulin units kg/day (p = 0.566), between diabetic patients with overweight or obesity and those with normal weight. From 2007 to 2018, the use of insulin analogs (p = 0.009) and a higher number of insulin doses (p = 0.007) increased significantly, with no increase in the prevalence of overweight and obesity.

Conclusions

The prevalence of overweight and obesity in diabetic children and adolescents increased in the 1990s and the beginning of the twenty-first century, with stabilization in the last decade. Metabolic control and DM1 treatment showed no association with this trend.
Literature
1.
go back to reference NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627–42. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627–42.
2.
go back to reference Pastor-Fajardo MT, Bosch-Giménez VM, Larqué E, Navarro CS, Fuentes-Castelló MÁ, Pastor-Rosado J. Child and Adolescent Obesity Prevalence and secular trend of childhood overweight and obesity in a Mediterranean area of Southeast Spain. Child Adolesc Obes. 2020;3(1):136–49.CrossRef Pastor-Fajardo MT, Bosch-Giménez VM, Larqué E, Navarro CS, Fuentes-Castelló MÁ, Pastor-Rosado J. Child and Adolescent Obesity Prevalence and secular trend of childhood overweight and obesity in a Mediterranean area of Southeast Spain. Child Adolesc Obes. 2020;3(1):136–49.CrossRef
3.
go back to reference Garrido-Miguel M, Cavero-Redondo I, Álvarez-Bueno C, Rodríguez-Artalejo F, Moreno LA, Ruiz JR, et al. Prevalence and Trends of Overweight and Obesity in European Children from 1999 to 2016: A Systematic Review and Meta-analysis. JAMA Pediatr. 2019;173(10): e192430.CrossRef Garrido-Miguel M, Cavero-Redondo I, Álvarez-Bueno C, Rodríguez-Artalejo F, Moreno LA, Ruiz JR, et al. Prevalence and Trends of Overweight and Obesity in European Children from 1999 to 2016: A Systematic Review and Meta-analysis. JAMA Pediatr. 2019;173(10): e192430.CrossRef
4.
go back to reference Patterson CC, Gyürüs E, Rosenbauer J, Cinek O, Neu A, Schober E, et al. Trends in childhood type 1 diabetes incidence in Europe during 1989–2008: Evidence of non-uniformity over time in rates of increase. Vol. 55, Diabetologia. 2012. p. 2142–7. Patterson CC, Gyürüs E, Rosenbauer J, Cinek O, Neu A, Schober E, et al. Trends in childhood type 1 diabetes incidence in Europe during 1989–2008: Evidence of non-uniformity over time in rates of increase. Vol. 55, Diabetologia. 2012. p. 2142–7.
5.
go back to reference Conde Barreiro S, Rodríguez Rigual M, Bueno Lozano G, López Siguero JP, González Pelegrín B, Rodrigo Val MP, et al. Epidemiology of type 1 diabetes mellitus in children in Spain. An Pediatr (Barc). 2014;81(3):189.e1-189.e12.CrossRef Conde Barreiro S, Rodríguez Rigual M, Bueno Lozano G, López Siguero JP, González Pelegrín B, Rodrigo Val MP, et al. Epidemiology of type 1 diabetes mellitus in children in Spain. An Pediatr (Barc). 2014;81(3):189.e1-189.e12.CrossRef
6.
go back to reference Mayer-Davis EJ, Lawrence JM, Dabelea D, Divers J, Isom S, Dolan L, et al. Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002–2012. N Engl J Med. 2017;376(15):1419–29.CrossRef Mayer-Davis EJ, Lawrence JM, Dabelea D, Divers J, Isom S, Dolan L, et al. Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002–2012. N Engl J Med. 2017;376(15):1419–29.CrossRef
7.
go back to reference Dubose SN, Hermann JM, Tamborlane WV, Beck RW, Dost A, Dimeglio LA, et al. Obesity in Youth with Type 1 Diabetes in Germany, Austria, and the United States. J Pediatr. 2015;167(3):627-632.e4.CrossRef Dubose SN, Hermann JM, Tamborlane WV, Beck RW, Dost A, Dimeglio LA, et al. Obesity in Youth with Type 1 Diabetes in Germany, Austria, and the United States. J Pediatr. 2015;167(3):627-632.e4.CrossRef
8.
go back to reference Chobot A, Górowska-Kowolik K, Sokołowska M, Jarosz-Chobot P. Obesity and diabetes—Not only a simple link between two epidemics. Diabetes Metab Res Rev. 2018;34(7):1–9.CrossRef Chobot A, Górowska-Kowolik K, Sokołowska M, Jarosz-Chobot P. Obesity and diabetes—Not only a simple link between two epidemics. Diabetes Metab Res Rev. 2018;34(7):1–9.CrossRef
9.
go back to reference Wilkin TJ. The convergence of type 1 and type 2 diabetes in childhood: The accelerator hypothesis Wilkin Convergence of type 1 and type 2 diabetes. Pediatr Diabetes. 2012;13(4):334–9.CrossRef Wilkin TJ. The convergence of type 1 and type 2 diabetes in childhood: The accelerator hypothesis Wilkin Convergence of type 1 and type 2 diabetes. Pediatr Diabetes. 2012;13(4):334–9.CrossRef
10.
go back to reference Abbasi A, Juszczyk D, van Jaarsveld CHM, Gulliford MC. Body Mass Index and Incident Type 1 and Type 2 Diabetes in Children and Young Adults: A Retrospective Cohort Study. J Endocr Soc. 2017;1(5):524–37.CrossRef Abbasi A, Juszczyk D, van Jaarsveld CHM, Gulliford MC. Body Mass Index and Incident Type 1 and Type 2 Diabetes in Children and Young Adults: A Retrospective Cohort Study. J Endocr Soc. 2017;1(5):524–37.CrossRef
11.
go back to reference Nathan DM. The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: Overview. Diabetes Care. 2014;37(1):9–16.CrossRef Nathan DM. The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: Overview. Diabetes Care. 2014;37(1):9–16.CrossRef
12.
go back to reference Liese AD, Ma X, Maahs DM, Trilk JL. Physical activity, sedentary behaviors, physical fitness, and their relation to health outcomes in youth with type 1 and type 2 diabetes: A review of the epidemiologic literature. J Sport Heal Sci. 2013;2(1):21–38.CrossRef Liese AD, Ma X, Maahs DM, Trilk JL. Physical activity, sedentary behaviors, physical fitness, and their relation to health outcomes in youth with type 1 and type 2 diabetes: A review of the epidemiologic literature. J Sport Heal Sci. 2013;2(1):21–38.CrossRef
13.
go back to reference Pinhas-Hamiel O, Levek-Motola N, Kaidar K, Boyko V, Tisch E, Mazor-Aronovitch K, et al. Prevalence of overweight, obesity and metabolic syndrome components in children, adolescents and young adults with type 1 diabetes mellitus. Diabetes Metab Res Rev. 2015;31(1):76–84.CrossRef Pinhas-Hamiel O, Levek-Motola N, Kaidar K, Boyko V, Tisch E, Mazor-Aronovitch K, et al. Prevalence of overweight, obesity and metabolic syndrome components in children, adolescents and young adults with type 1 diabetes mellitus. Diabetes Metab Res Rev. 2015;31(1):76–84.CrossRef
15.
go back to reference Mayer-Davis EJ, Kahkoska AR, Jefferies C, Dabelea D, Balde N, Gong CX, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2018;19(June):7–19.CrossRef Mayer-Davis EJ, Kahkoska AR, Jefferies C, Dabelea D, Balde N, Gong CX, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2018;19(June):7–19.CrossRef
16.
go back to reference Pastor J, Bosch V, Fajardo MT, Goberna F, Vargas F. Diferencias de estado nutricional, control metabólico y tratamiento de la diabetes tipo 1 en dos décadas. An Pediatr. 2011;75(4):259–65.CrossRef Pastor J, Bosch V, Fajardo MT, Goberna F, Vargas F. Diferencias de estado nutricional, control metabólico y tratamiento de la diabetes tipo 1 en dos décadas. An Pediatr. 2011;75(4):259–65.CrossRef
17.
go back to reference Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. Br Med J. 2000;320(7244):1240–3.CrossRef Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. Br Med J. 2000;320(7244):1240–3.CrossRef
18.
go back to reference Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes. 2012;7(4):284–94.CrossRef Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes. 2012;7(4):284–94.CrossRef
19.
go back to reference Hanas R, John G. Consensus statement on the worldwide standardization of the hemoglobin A1C measurement. Diabetes Care. 2010;2010:1903–4.CrossRef Hanas R, John G. Consensus statement on the worldwide standardization of the hemoglobin A1C measurement. Diabetes Care. 2010;2010:1903–4.CrossRef
20.
go back to reference Nathan DM, Cleary PA, Backlund JC, Genuth SM, Lachin JM, Orchard TJ, Raskin Ph ZB. Intensive Diabetes Treatment and Cardiovascular Disease in Patients with Type 1 Diabetes. N Engl J Med. 2005;353(25):2643–53.CrossRef Nathan DM, Cleary PA, Backlund JC, Genuth SM, Lachin JM, Orchard TJ, Raskin Ph ZB. Intensive Diabetes Treatment and Cardiovascular Disease in Patients with Type 1 Diabetes. N Engl J Med. 2005;353(25):2643–53.CrossRef
21.
go back to reference Chiang JL, Kirkman MS, Laffel LMB, Peters AL. Type 1 diabetes through the life span: A position statement of the American Diabetes Association. Diabetes Care. 2014;37(7):2034–54.CrossRef Chiang JL, Kirkman MS, Laffel LMB, Peters AL. Type 1 diabetes through the life span: A position statement of the American Diabetes Association. Diabetes Care. 2014;37(7):2034–54.CrossRef
22.
go back to reference Sevaliev N, Strich D, Avnon-Ziv C, Levy-Khademi F. The metabolic consequences of overweight in a cohort of children with type 1 diabetes. J Pediatr Endocrinol Metab. 2019;32(7):715–9.CrossRef Sevaliev N, Strich D, Avnon-Ziv C, Levy-Khademi F. The metabolic consequences of overweight in a cohort of children with type 1 diabetes. J Pediatr Endocrinol Metab. 2019;32(7):715–9.CrossRef
23.
go back to reference Gimenez M, Aguilera E, Castell C, de Lara N, Nicolau J, Conget I. Relationship Between BMI and Age at Diagnosis of Type 1 Diabetes in a Mediterranean Area in the Period of 1990–2004. Diabetes Care. 2007;30(6):1593–5.CrossRef Gimenez M, Aguilera E, Castell C, de Lara N, Nicolau J, Conget I. Relationship Between BMI and Age at Diagnosis of Type 1 Diabetes in a Mediterranean Area in the Period of 1990–2004. Diabetes Care. 2007;30(6):1593–5.CrossRef
24.
go back to reference Maffeis C, Birkebaek NH, Konstantinova M, Schwandt A, Vazeou A, Casteels K, et al. Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry. Pediatr Diabetes. 2018;19(7):1211–20.CrossRef Maffeis C, Birkebaek NH, Konstantinova M, Schwandt A, Vazeou A, Casteels K, et al. Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry. Pediatr Diabetes. 2018;19(7):1211–20.CrossRef
25.
go back to reference Nansel TR, Lipsky LM, Iannotti RJ. Cross-sectional and longitudinal relationships of body mass index with glycemic control in children and adolescents with type 1 diabetes mellitus. Diabetes Res Clin Pract. 2013;100(1):126–32.CrossRef Nansel TR, Lipsky LM, Iannotti RJ. Cross-sectional and longitudinal relationships of body mass index with glycemic control in children and adolescents with type 1 diabetes mellitus. Diabetes Res Clin Pract. 2013;100(1):126–32.CrossRef
26.
go back to reference Babar G, Clements M, Dai H, Raghuveer G. Assessment of biomarkers of inflammation and premature atherosclerosis in adolescents with type-1 diabetes mellitus. J Pediatr Endocrinol Metab. 2019;32(2):109–13.CrossRef Babar G, Clements M, Dai H, Raghuveer G. Assessment of biomarkers of inflammation and premature atherosclerosis in adolescents with type-1 diabetes mellitus. J Pediatr Endocrinol Metab. 2019;32(2):109–13.CrossRef
27.
go back to reference Fullerton B, Jeitler K, Seitz M, Horvath K, Berghold A, Siebenhofer A. Intensive glucose control versus conventional glucose control for type 1 diabetes mellitus. Cochrane Database Syst Rev. 2014;2014(2):CD009122. Fullerton B, Jeitler K, Seitz M, Horvath K, Berghold A, Siebenhofer A. Intensive glucose control versus conventional glucose control for type 1 diabetes mellitus. Cochrane Database Syst Rev. 2014;2014(2):CD009122.
28.
go back to reference Corbin KD, Driscoll KA, Pratley RE, Smith SR, Maahs DM, Mayer-Davis EJ. Obesity in type 1 diabetes: Pathophysiology, clinical impact, and mechanisms. Endocr Rev. 2018;39(5):629–63.CrossRef Corbin KD, Driscoll KA, Pratley RE, Smith SR, Maahs DM, Mayer-Davis EJ. Obesity in type 1 diabetes: Pathophysiology, clinical impact, and mechanisms. Endocr Rev. 2018;39(5):629–63.CrossRef
29.
go back to reference Liese AD. The burden of diabetes mellitus among US youth: Prevalence estimates from the SEARCH for Diabetes in Youth Study: SEARCH for Diabetes in Youth Study Group. Pediatrics. 2006;118(4):1510–8.CrossRef Liese AD. The burden of diabetes mellitus among US youth: Prevalence estimates from the SEARCH for Diabetes in Youth Study: SEARCH for Diabetes in Youth Study Group. Pediatrics. 2006;118(4):1510–8.CrossRef
30.
go back to reference Hamman RF, Bell RA, Dabelea D, D’Agostino RB, Dolan L, Imperatore G, et al. The SEARCH for diabetes in youth study: Rationale, findings, and future directions. Diabetes Care. 2014;37(12):3336–44.CrossRef Hamman RF, Bell RA, Dabelea D, D’Agostino RB, Dolan L, Imperatore G, et al. The SEARCH for diabetes in youth study: Rationale, findings, and future directions. Diabetes Care. 2014;37(12):3336–44.CrossRef
31.
go back to reference Fellinger P, Fuchs D, Wolf P, Heinze G, Luger A, Krebs M, et al. Overweight and obesity in type 1 diabetes equal those of the general population. Wien Klin Wochenschr. 2019;131(3–4):55–60.CrossRef Fellinger P, Fuchs D, Wolf P, Heinze G, Luger A, Krebs M, et al. Overweight and obesity in type 1 diabetes equal those of the general population. Wien Klin Wochenschr. 2019;131(3–4):55–60.CrossRef
33.
go back to reference Censin JC, Nowak C, Cooper N, Bergsten P, Todd JA, Fall T. Childhood adiposity and risk of type 1 diabetes: A Mendelian randomization study. PLoS Med. 2017 Aug 1;14(8). Censin JC, Nowak C, Cooper N, Bergsten P, Todd JA, Fall T. Childhood adiposity and risk of type 1 diabetes: A Mendelian randomization study. PLoS Med. 2017 Aug 1;14(8).
34.
go back to reference Vestberg D, Rosengren A, Olsson M, Gudbjörnsdottir S, Svensson AM, Lind M. Relationship between overweight and obesity with hospitalization for heart failure in 20,985 patients with type 1 diabetes: A population-based study from the Swedish National Diabetes Registry. Diabetes Care. 2013;36(9):2857–61.CrossRef Vestberg D, Rosengren A, Olsson M, Gudbjörnsdottir S, Svensson AM, Lind M. Relationship between overweight and obesity with hospitalization for heart failure in 20,985 patients with type 1 diabetes: A population-based study from the Swedish National Diabetes Registry. Diabetes Care. 2013;36(9):2857–61.CrossRef
Metadata
Title
Changes from 1986 to 2018 in the prevalence of obesity and overweight, metabolic control and treatment in children with type 1 diabetes mellitus in a Mediterranean area of Southeast Spain
Authors
María Teresa Pastor-Fajardo
María Teresa Fajardo-Giménez
Vicente María Bosch-Giménez
José Pastor-Rosado
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2022
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-022-03330-1

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