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Trends in BMI in Latin American Children With New-Onset Type 1 Diabetes Over 3 Years

Valeria Hirschler1, Claudia Molinari2, Maria Eugenia Andres3

  • 1Department of Epidemiology, Argentine Diabetes Society, Buenos Aires, Argentina.

Clinical Diabetes : a Publication of the American Diabetes Association
|January 20, 2025
PubMed

Insights

Children with new-onset type 1 diabetes show increasing BMI z-scores over three years, influenced by insulin dose. Despite rising insulin, A1C control remained suboptimal, indicating a need for improved management strategies.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Disorders

Background:

  • Type 1 diabetes (T1D) management in children requires careful attention to metabolic control and growth.
  • Obesity and weight gain are increasingly recognized concerns in pediatric T1D populations.
  • Understanding the interplay between body mass index (BMI), insulin therapy, and glycemic control is crucial for long-term outcomes.

Purpose of the Study:

  • To analyze trends in BMI z-score (z-BMI) in children with new-onset T1D.
  • To investigate the correlation between z-BMI, insulin dose, and glycated hemoglobin A1C (HbA1c).
  • To evaluate the effectiveness of insulin therapy in managing glycemic control in this cohort.

Main Methods:

  • Retrospective analysis of clinical data from pediatric patients with new-onset T1D across multiple Latin American centers.
  • Tracking of z-BMI, insulin dosage, and HbA1c levels over a 3-year follow-up period.
  • Statistical analysis to identify significant trends and covariates, including insulin dose's impact on z-BMI and A1C.

Main Results:

  • A significant increase in z-BMI was observed from T1D onset through the 3-year follow-up.
  • Insulin dose emerged as a significant covariate influencing z-BMI trends.
  • Despite a steady increase in insulin doses, mean HbA1c remained high at 8.7%, suggesting suboptimal glycemic control.

Conclusions:

  • Children with new-onset T1D experience progressive increases in z-BMI during the initial years post-diagnosis.
  • Insulin therapy, while increasing, may not be sufficient to optimize glycemic control (A1C) in the context of rising z-BMI.
  • Further research is needed to explore integrated strategies for managing weight and glycemic control in pediatric T1D.

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