Children with Type 1 Diabetes: Body Composition Changes in the First Year after Diagnosis
Researchers Look at Cardiovascular Risk and Glycemic Control
It’s known that rapid weight gain often follows the initiation of insulin therapy in children who have type 1 diabetes. Girls in particular are at risk of becoming overweight when starting insulin therapy.
In a study, researchers looked at the body composition changes in children in the first year after being diagnosed with type 1 diabetes; and they related this to cardiovascular risk markers.
They published their findings online in January 2012 in the article “Body composition in children with type 1 diabetes in the first year after diagnosis: relationship to glycaemic control and cardiovascular risk.” The article will soon appear in the journal Archives of Disease in Childhood.
Body mass index (BMI) and body composition, which was measured using whole body dual energy x-ray absorptiometry (DXA), were assessed at 3 points in 30 study participants (18 boys and 12 girls) with type 1 diabetes: 3 to 10 days after the diagnosis, 6 weeks later, and at 1 year.
In addition, cardiovascular risk markers were evaluated in the patients with type 1 diabetes 1 year after diagnosis.
There was a control group in the study; it had 8 boys and 6 girls in it. Researchers assessed their BMI and body composition on 2 occasions 1 year apart.
The research team found that the participants who had type 1 diabetes had lower BMI SD scores (SDS) at diagnosis than the participants in the control group (mean [SD] BMI SDS: -0.67 (1.34) vs 0.20 (1.14); p<0.05) and a reduced percentage of body fat (20.3% (4.6) vs 24.5% (7.7); p<0.05).
They noted that the participants who had type 1 diabetes normalized their body composition at 6 weeks, which was also maintained 1 year later.
The researchers also noted that the girls who had type 1 diabetes were thinner than the boys both at diagnosis (BMI SDS: -1.64 (1.02) vs -0.02 (1.17); p<0.05) and at 1 year after diagnosis (BMI SDS: -0.58(0.9) vs 0.65 (0.98); p<0.05).
Additionally, the research team found that the girls had higher:
- glycated hemoglobin (HbA1c) levels (8.8% (1.2) vs 7.8% (1.0); p<0.05)
- insulin dose (1.01 (0.30) vs 0.82 (0.18) U/kg/day; p=0.04)
- total cholesterol levels (4.30 (0.45) vs 3.79 (0.50) mmol/l; p<0.05)
- high-density lipoprotein levels (2.62 (0.53) vs 2.02 (0.37) mmol/l)
In this study, the researchers found that both high-sensitivity C-reactive protein and fibrinogen were in the normal range, and there were no differences between the genders in regard to these 2 measurements.
They concluded that insulin deficiency at the diagnosis of type 1 diabetes causes a catabolic state that is pre-dominantly lipolytic.
The researchers found that body composition normalizes within 6 weeks of treatment—even though girls are thinner than boys both at diagnosis and at 1 year after diagnosis, which is contrary to published findings. Although the girls in the study were prescribed a larger insulin dose, their HbA1c levels and cholesterol levels were higher 1 year after being diagnosed with type 1 diabetes; this suggests both increased insulin resistance and cardiovascular risk in these patients.