Peer-reviewed article
Overweight and obesity in youth with type 1 diabetes.
H Javier Velasquez, Xiaofan Huang, Charles Minard, Alejandro F Siller, Raquel M Gupta et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how common overweight and obesity become in children and teenagers with type 1 diabetes who started out at a healthy weight. Over 2.4 years, about one-third of these young people developed overweight or obesity. Girls were more likely than boys to gain excess weight, and those with lower blood sugar control at diagnosis were also at higher risk. The findings suggest that identifying at-risk youth early could help doctors provide better weight-management support after a diabetes diagnosis.
Key points
- 64.8% of 1,394 lean youth with new-onset type 1 diabetes remained lean over median 29.2 months; 26.7% developed overweight and 8.5% developed obesity
- Female sex was significantly associated with development of both overweight (p<0.001) and obesity (p=0.003)
- Lower hemoglobin A1c at baseline was associated with developing overweight (p<0.001)
- Multiple positive islet autoantibodies at baseline were associated with developing overweight (p=0.026)
- No statistically significant associations found with age at diagnosis, health insurance type, or thyroid/celiac antibodies
Limitations
The study does not evaluate an intervention or its effectiveness, so it cannot tell us what works to prevent weight gain in youth with type 1 diabetes. The document also does not provide information about the mechanisms explaining why these factors increase risk or about longer-term outcomes beyond 2.4 years.
Abstract
OBJECTIVES: Overweight and obesity are highly prevalent in the general population but remain understudied in pediatric type 1 diabetes (T1D). We aimed to estimate the incidence and identify associated factors for developing elevated BMI in a contemporary, real-world cohort of racially diverse lean youth with new-onset T1D. METHODS: We reviewed medical records from 1,394 youth who were lean (BMI <85th percentile) at the onset of T1D between 2012 and 2024 (excluding those with thyroid or celiac diseases at any time), used BMI trajectory to stratify into mutually exclusive categories (stayed lean, developed overweight, or developed obesity), compared these for baseline characteristics, and estimated relative risk of becoming overweight or obese. RESULTS: Over a median of 29.2 months, 64.8 % of youth remained lean, 26.7 % developed overweight, and 8.5 % obesity. We identified significant baseline factors associated with the development of overweight (female, p<0.001; having multiple positive islet autoantibodies, p=0.026; and having lower hemoglobin A1c, p<0.001) and obesity (female, p=0.003). There were no statistically significant associations with age at T1D diagnosis, health insurance type, or positivity for thyroid or celiac antibodies. CONCLUSIONS: In sum, over 33 % of lean youth developed elevated BMI within a median of 2.4 years after T1D onset. Early identification of characteristics associated with incident overweight and obesity in youth with T1D may inform targeted weight-management interventions following diagnosis.