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Overweight, obesity and features of metabolic syndrome in children with diabetes treated with insulin pump therapy

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Abstract

There has been no specific evaluation of atherogenic risk factors in children with type 1 diabetes mellitus (T1DM) treated with continuous subcutaneous insulin infusion (CSII). We, therefore, studied the prevalence of overweight/obesity and metabolic syndrome among these patients. Five hundred children with T1DM treated with CSII and multiple daily insulin (MDI) regimen were included in the study. Anthropometric data/physical examination, data concerning diabetes, and a lipid profile were assessed in this group, and compared with respect to treatment method (CSII vs. MDI). Almost one-third (30.2%) of the children were overweight/obese. The body mass index (BMI) values at the time of the present evaluation were significantly higher in comparison with the BMI values 3–6 months after the diagnosis. Dyslipidemia was recognized in 51.6%, hypertension in 4.8%, and the metabolic syndrome in 3.2%. of the subjects. The overweight/obese children differed from their normal-weight counterparts with respect to metabolic control, the incidence of hypertension, dyslipidemia, and metabolic syndrome. The girls showed higher prevalence of overweight/obesity and higher BMI values compared to the boys. The children treated with CSII had the same prevalence of overweight/obesity, but a lower incidence of dyslipidemia, and a better metabolic control compared to the children treated with MDI regimen. Our study shows a high prevalence of overweight/obesity and dyslipidemia in children with T1DM including those treated with an insulin pump.

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Abbreviations

BMI:

body mass index

CSII:

continuous subcutaneous insulin infusion

CVD:

cardiovascular diseases

DM:

diabetes mellitus

FMDI:

flexible multiple daily insulin regimen

IDF:

International Diabetes Federation

MDI:

multiple daily insulin regimen

MS:

metabolic syndrome

T1DM:

type 1 diabetes mellitus

References

  1. Alemzadeh R, Berhe T, Wyatt DT (2005) Flexible insulin therapy with glargine insulin improved glycemic control and reduced severe hypoglycemia among preschool-aged children with type 1 diabetes mellitus. Pediatrics 115:1320–1324

    Article  PubMed  Google Scholar 

  2. Arcanjo CL, Piccirillo LJ, Machado IV et al (2005) Lipid profile and anthropometrical evaluation in type 1 diabetes. Arq Bras Endocrinol Metabol 49:951–958

    Article  PubMed  Google Scholar 

  3. Bergenstal RM, Tamborlane WV, Ahmann A et al (2010) Effectiveness of sensor-augmented insulin-pump therapy in type 1 diabetes. N Engl J Med 363:311–320

    Article  PubMed  CAS  Google Scholar 

  4. Boland EA, Grey M, Oesterle A et al (1999) Continuous subcutaneous insulin infusion. A new way to lower risk of severe hypoglycemia, improve metabolic control and enhance coping in adolescents with type 1 diabetes. Diabetes Care 22:1779–1784

    Article  PubMed  CAS  Google Scholar 

  5. Group TDR (1988) Weight gain associated with intensive therapy in the diabetes control and complications trial. The DCCT Research Group. Diabetes Care 11:567–573

    Article  Google Scholar 

  6. Ingberg CM, Sarnblad S, Palmer M et al (2003) Body composition in adolescent girls with type 1 diabetes. Diabet Med 20:1005–1011

    Article  PubMed  Google Scholar 

  7. Jeitler K, Horvath K, Berghold A et al (2008) Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Diabetologia 51:941–951

    Article  PubMed  CAS  Google Scholar 

  8. Juliusson PB, Graue M, Wentzel-Larsen T, Sovik O (2006) The impact of continuous subcutaneous insulin infusion on health-related quality of life in children and adolescents with type 1 diabetes. Acta Paediatr 95:1481–1487

    Article  PubMed  Google Scholar 

  9. Krishnan S, Short KR (2009) Prevalence and significance of cardiometabolic risk factors in children with type 1 diabetes. J Cardiometab Syndr 4:50–56

    Article  PubMed  Google Scholar 

  10. Kułaga Z, Litwin M, Zajączkowska MM et al (2008) Porównanie wartości obwodów talii i bioder dzieci i młodzieży polskiej w wieku 7–18 lat z wartościami referencyjnymi dla oceny ryzyka sercowo-naczyniowego - wyniki wstępne projektu badawczego OLAF (PL0080). Stand Med 5:473–485

    Google Scholar 

  11. Lawrence JM, Liese AD, Liu L et al (2008) Weight-loss practices and weight-related issues among youth with type 1 or type 2 diabetes. Diabetes Care 31:2251–2257

    Article  PubMed  Google Scholar 

  12. Libman IM, Pietropaolo M, Arslanian SA et al (2003) Changing prevalence of overweight children and adolescents at onset of insulin-treated diabetes. Diabetes Care 26:2871–2875

    Article  PubMed  Google Scholar 

  13. Maniatis AK, Klingensmith GJ, Slover RH et al (2001) Continuous subcutaneous insulin infusion therapy for children and adolescents: an option for routine diabetes care. Pediatrics 107:351–356

    Article  PubMed  CAS  Google Scholar 

  14. Monami M, Lamanna C, Marchionni N, Mannucci E (2010) Continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 1 diabetes: a meta-analysis. Acta Diabetol. In press

  15. Mortensen HB, Hougaard P, Swift P et al (2009) New definition for the partial remission period in children and adolescents with type 1 diabetes. Diabetes Care 32:1384–1390

    Article  PubMed  CAS  Google Scholar 

  16. Newfield RS, Cohen D, Capparelli EV, Shragg P (2009) Rapid weight gain in children soon after diagnosis of type 1 diabetes: is there room for concern ? Pediatr Diabetes 10:310–315

    Article  PubMed  Google Scholar 

  17. Patterson CC, Dahlquist GG, Gyürüs E et al (2009) Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. Lancet 373:2027–2033

    Article  PubMed  Google Scholar 

  18. Pietilainen KH, Virtanen SM, Rissanen A et al (1995) Diet, obesity, and metabolic control in girls with insulin dependent diabetes mellitus. Arch Dis Child 73:398–402

    Article  PubMed  CAS  Google Scholar 

  19. Reinehr T, Holl RW, Roth CL et al (2005) Insulin resistance in children and adolescents with type 1 diabetes mellitus: relation to obesity. Pediatr Diabetes 6:5–12

    Article  PubMed  Google Scholar 

  20. Russell-Jones D, Khan R (2007) Insulin-associated weight gain in diabetes - causes, effects and coping strategies. Diabetes Obes Metab 9:799–812

    Article  PubMed  CAS  Google Scholar 

  21. Schwab KO, Doerfer J, Hecker W et al (2006) Spectrum and prevalence of atherogenic risk factors in 27, 358 children, adolescents, and young adults with type 1 diabetes. Diabetes Care 29:218–225

    Article  PubMed  Google Scholar 

  22. Silverstein J, Klingensmith G, Copeland K et al (2005) Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 28:186–212

    Article  PubMed  Google Scholar 

  23. Strauss RS, Pollack HA (2001) Epidemic increase in childhood overweight, 1986–1998. JAMA 286:2845–2848

    Article  PubMed  CAS  Google Scholar 

  24. Szadkowska A, Pietrzak I, Szlawska J et al (2009) Abdominal obesity, metabolic syndrome in type 1 diabetic children and adolescents. Pediatr Endocrinol Diabetes Metab 15:233–239

    PubMed  CAS  Google Scholar 

  25. van Vliet M, van der Heyden JC, Diamant M et al (2010) Overweight is highly prevalent in children with type 1 diabetes and associates with cardiometabolic risk. J Pediatr 156:923–929

    Article  PubMed  Google Scholar 

  26. Williams KV, Erbey JR, Becker D, Orchard TJ (1999) Improved glycemic control reduces the impact of weight gain on cardiovascular risk factors in type 1 diabetes. The Epidemiolgy of Diabetes Complications Study. Diabetes Care 22:1084–1091

    Article  PubMed  CAS  Google Scholar 

  27. Zimmet P, Alberti KG, Kaufman F et al (2007) The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes 8:299–306

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Białystok, Białystok, Poland

    Włodzimierz Łuczyński, Barbara Głowińska-Olszewska & Artur Bossowski

  2. Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland

    Agnieszka Szypowska

Authors
  1. Włodzimierz Łuczyński
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  2. Agnieszka Szypowska
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  3. Barbara Głowińska-Olszewska
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  4. Artur Bossowski
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Correspondence to Włodzimierz Łuczyński.

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Łuczyński, W., Szypowska, A., Głowińska-Olszewska, B. et al. Overweight, obesity and features of metabolic syndrome in children with diabetes treated with insulin pump therapy. Eur J Pediatr 170, 891–898 (2011). https://doi.org/10.1007/s00431-010-1372-7

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  • DOI: https://doi.org/10.1007/s00431-010-1372-7

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