Obesity in pediatric type 1 diabetes: an underestimated health problem.
AIM To determine the prevalence of overweight and obesity among youth with type 1 diabetes (T1D) in a multi-ethnic cohort and examine associations with clinical characteristics. METHODS We conducted a retrospective study of all participants enrolled in the Accurate Diagnosis in Diabetes for Appropriate Management (ADDAM) Biobank at the Montreal Children's Hospital (n = 352). Logistic regression was used to evaluate associations between overweight/obesity (BMI ≥ 85th percentile for age and sex) and age, sex, diabetes duration, hemoglobin A1C, genetic ancestry, and weight-adjusted total daily insulin dose. RESULTS Overall, 70.5% of participants had BMI < 85th percentile, while 29.5% had BMI ≥ 85th percentile, including 10.7% with obesity (BMI > 95th percentile). Higher weight-adjusted total daily insulin dose was independently associated with BMI ≥ 85th percentile. However, when analyses were restricted to participants with obesity, this association was no longer statistically significant after multivariable adjustment (P = 0.06). CONCLUSIONS Nearly one-third of youth with T1D in this cohort had overweight or obesity. Higher weight-adjusted insulin requirements may reflect increased insulin resistance in this population. Further studies are needed to identify modifiable risk factors and inform obesity prevention strategies in youth with T1D.