Nottingham University Hospitals, Nottingham, UK.
Obesity is a growing epidemic and a major cause of morbidity and mortality. Maintaining a healthy weight is of even greater importance for diabetics, due to the increased risk of micro-vascular and macro-vascular complications.
There is suggestion that type 1 diabetic children are more likely to be obese than their peers (e.g. Type 1 diabetes children often overweight, www.diabetes.co.uk/news). In our study the BMIs of 262 children (aged 215 years), with type 1 diabetes, were compared with the background population (using UK90, National Child Measurement Programme and Health Survey for England data 2008).
Our population was found to have a mean BMI 1.0 standard deviation above the mean for age (85th centile, UK90 data). 26.3% (95% CI 21.432.4%) were obese (BMI>95th centile).
These results are consistent with the trend of increasing obesity over the last 30 years. However, when compared with the current national prevalence of 16% (HSE, 2008), our population of type 1 diabetics were significantly more likely to be obese. Obesity rates in younger patients (25.3% in 210-year-old) were not statistically different from older patients (27.0% in 1115-year-old), in contrast to the background population (210 years 13.9%, 1115 19.5%).
We now need to look at possible reasons for the difference in obesity rates so that therapeutic options can be devised. We plan to do further subset analysis to look at demographic factors and sex differences. We will also look at the effect on BMI of different insulin regimes and on ways of treating hypoglycaemia. With this increased awareness of the problem we will look at methods of continuing to promote healthy diets but with an increased emphasis on maintaining a normal BMI from diagnosis without inducing disordered eating behaviour and manipulation of insulin to achieve this.