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Body mass index standard deviation score and obesity in children with type 1 diabetes in the Nordic countries. HbA(1c) and other predictors of increasing BMISDS
Aarhus Univ, Denmark.
Aarhus Univ Hosp, Denmark.
Landspitali Univ Hosp, Iceland; Univ Iceland, Iceland.
Oslo Univ Hosp, Norway.
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2018 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 19, no 7, p. 1198-1205Article in journal (Refereed) Published
Abstract [en]

Background: Intensified insulin therapy may increase body weight and cause obesity. This study compared body mass index standard deviation score (BMISDS) and obesity rate in children with type 1 diabetes (T1D) in Denmark, Iceland, Norway and Sweden, and uncovered predictors for increasing BMISDS. Methods: Data registered in the Nordic national childhood diabetes databases during the period 2008-2012 on children below 15 years with T1D for more than 3 months were compiled, including information on gender, age, diabetes duration, hemoglobin A(1c) (HbA(1c)), insulin dose, severe hypoglycemia (SH), treatment modality, height and weight. The Swedish reference chart for BMI was used for calculating BMISDS. Results: Totally, 11025 children (48% females) (30994 registrations) were included. Medians by the last recorded examination were: age, 13.5 years; diabetes duration, 4.3 years; HbA(1c), 7.9% (63 mmol/mol); insulin dose, 0.8 IU/kg/d and BMISDS, 0.70. Obesity rate was 18.5%. Adjusted mean BMISDS (BMISDS adj) was inversely related to HbA(1c) and directly to diabetes duration. Higher BMISDS adj was found in those with an insulin dose above 0.6 IU/kg/d, and in girls above 10 years. Pump users had higher BMISDS adj than pen users, and patients with registered SH had higher BMISDS adj than patients without SH (both P amp;lt; .001). Conclusion: Obesity rate in children with T1D in the Nordic countries is high, however, with country differences. Low HbA(1c), long diabetes duration, higher insulin dose, pump treatment and experiencing a SH predicted higher BMISDS. Diabetes caregivers should balance the risk of obesity and the benefit of a very low HbA(1c).

Place, publisher, year, edition, pages
WILEY , 2018. Vol. 19, no 7, p. 1198-1205
Keywords [en]
BMISDS; HbA(1c); insulin therapy modality; Nordic countries; obesity risk factors
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:liu:diva-152371DOI: 10.1111/pedi.12693ISI: 000446564900008PubMedID: 29781227OAI: oai:DiVA.org:liu-152371DiVA, id: diva2:1260706
Note

Funding Agencies|Health Research Fund of Central Denmark Region; Program for Clinical Research Infrastructure (PROCRIN); The Swedish Board of Health and Welfare; Swedish Association of Local Authorities and Regions; The Danish Regions Clinical Quality Development Programme; The South-Eastern Norway Regional Health Authority

Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2018-11-05

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Samuelsson, Ulf
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Division of Children's and Women's healthFaculty of Medicine and Health SciencesH.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus
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