Endocrine Abstracts

Introduction: Total daily insulin required to achieve glycaemic control in type 1 diabetes (T1D) depends on numerous factors. Correlation of insulin requirement to BMI and waist circumference has been variably reported in the literature, whilst that of WHtR has not been studied.

Aims: To study the correlation between daily insulin requirement (TDD) and WHtR in a multi-ethnic population.

Methods: A cross-sectional study of children (5–18 years) with T1D attending a diabetes clinic in a multi-ethnic population in Bradford, UK was conducted. Physical measurements were undertaken in the clinic setting and data collected from case notes and patients/carers. Ethnicity was classified using the Office of National Statistics recommended country specific ethnic group question. Deprivation was allocated using the index of multiple deprivation (IMD) based on current postcode.

Results: Sixty-nine patients with mean age 12.7 (±3.1) years, duration of diabetes 5.4 (±3.5) years, and HbA1c 80 (±18) mmol/mol were recruited. Nearly 54% (n=37) were white and 46% were non-white (29 Asian Pakistani, one Indian, and two mixed White Afro-Caribbean). The two ethnic groups had similar demographics and disease profile. Compared to whites, non whites had a higher prevalence of obesity (15% vs 5%, P<0.01), family history of T2D (49% vs 33%), microalbuminuria (22% vs 11%, P<0.05), and deprivation (mean IMD score 42 vs 30, P<0.001). WHtR and TDD were poorly correlated in the whole group. However, significant positive correlation was seen in whites (r=0.583, n=37, P<0.01) and significant negative correlation seen in Asian Pakistanis (r=−0.472, n=32, P<0.01); significant negative correlation was also seen in subjects with relatives with T2D (r=−0.86, n=6, P=0.02).

Conclusions: The variation in correlations highlights that the two ethnic groups behave differently and should therefore be studied separately with regards to factors influencing insulin requirements with careful consideration to the presence of parental IR.