Increased insulin requirement may contribute to risk of obesity in children and young people with Type 1 Diabetes Mellitus

IntroductionType 1 diabetes mellitus (T1DM) is an autoimmune disorder that interferes with the function of the beta cells in the pancreas. Reports show that the incidence of T1DM is increasing throughout England and Wales, along with the Body Mass Index (BMI) of this patient group. The association between type 2 diabetes mellitus (T2DM) and obesity is recognised, but literature describing the association between T1DM and high BMI is more limited.The aim of this paper is to identify factors affecting BMI and the impact that this increasing trend has on children and young people with T1DM.MethodsInformation was obtained from the medical records of patients with T1DM at the local paediatric centre. BMI standard deviation scores (SDS) were calculated and compared to other factors, which include insulin requirement, HbA1c, pubertal status and age at diagnosis.ResultsThis study involved 102 patients (43 male and 59 female). The mean age at diagnosis was 7.79 years (range from 0.16 to 16.91 years). Our results showed a significant association between insulin requirement and BMI SDS (r = 0.23, p = 0.02) and a significant association between insulin requirement and mean HbA1c (r = 0.59, p=<0.01). A multivariable regression analysis of factors affecting BMI SDS showed that insulin requirement was an independent factor affecting BMI SDS.ConclusionThere were significant associations between increased insulin requirement, high BMI SDS and poorer glycaemic control. Further research is required to fully understand the risk factors that may contribute to obesity in T1DM.