Endocrine Abstracts

Objective: Catch-up growth might be associated with metabolic risk later in life. The β-cell has a higher energy requirement and poor antioxidant defense. The accelerator hypothesis predicts earlier onset in heavier people, without necessarily a change in risk, and views diabetes as the one disorder of insulin resistance, set against different genetic backgrounds. Insulin resistance is a function of fat mass, and increasing body weight is accompanied by earlier presentation (acceleration) of diabetes. We wanted to establish whether increasing body weight was associated with the earlier presentation of type 1 diabetes, as the hypothesis would predict.

Research design and methods: The relationships between fatness and age at diagnosis were examined in context of birth weight, weight change since birth, weight and BMI at diagnosis in 130 children aged 1–16 years presenting for management of acute-onset type 1 diabetes.

Results: BMI SDS at diagnosis and weight SDS change since birth were inversely related to age at presentation in mostly children. The girls were fatter than the boys and presented with diabetes at a younger age. The sex difference in age at diagnosis were no significant when corrected for BMI suggesting that something related to fatness was the responsible factor.

Conclusions: The important question is how we can best fine-tune the nutritional intakes while maintaining neurodevelopment without cause long-term metabolic consequences. The implications for prevention of type 1 diabetes may be important.

Abbreviations: SDS, BMI, acceleration, diabetes mellitus, prevention.