Endocrine Abstracts

Aim: To compare the BMI z-score of children with type 1 diabetes (T1DM) in Nottingham with that of national and local background populations and to identify factors associated with increased BMI.

Methods: A retrospective observational cohort study of patients with T1DM aged 2–15 years under the care of the paediatric diabetes team at Nottingham Children’s Hospital, between April 2013 and March 2014. Mean BMI-z-score for the year was computed in R, utilising publically available LMS data from the UK 1990 cohort. This was compared with BMI z-score of age-matched children from i) the National Child Measurement Programme (NCMP) ii) the Health Survey for England (HSE) data for the same year and iii) our 2008 audit data. Overweight and obesity was defined as a BMI>85th (BMI z-score >1.0) and >95th (BMI z-score >1.6) centiles, respectively.

Results: 1140 clinic entries were analysed relating to 253 patients. The mean±S.E.M. BMI-z-score was 0.62±0.004, with 16% of patients being obese and a further 15.2% overweight, similar to national rates (15.2% and 14.2% (HSE)). Compared to previous data, obesity rates and mean BMI-z-score had improved (26.3% obese, P=0.005; mean BMI z-score 1.0, P<0.001). Younger age group female patients (2–10 years) had a higher mean z-score than males (0.63±0.13 vs 0.44±0.46, P=0.24) but this was not significant. No gender trend was noted in older children (11–15 years). 2–4 year old females (1.03±0.16) had the highest z-score.

Conclusion: Obesity and mean BMI-z-score in T1DM in Nottingham have improved significantly and are now comparable to the national background population. In contrast to previously published evidence, the children with T1DM in Nottingham are not obese compared to the general population. This study does now allow any firm conclusions to be drawn, but possibilities for local improvement could include an increase in multidisciplinary support from dietitians and specialist nurses, targeted better management leading to fewer hypoglycaemic episodes and a general plateau in obesity.