BMI is an important driver of β-cell loss in type 1 diabetes upon diagnosis in 10 to 18-year-old children

A. Lauria, A. Barker, N. Schloot, N. Hosszufalusi, J. Ludvigsson, C. Mathieu, D. Mauricio, M. Nordwall, B. Van Der Schueren, T. Mandrup-Poulsen, W. A. Scherbaum, I. Weets, F. K. Gorus, N. Wareham, R. D. Leslie, P. Pozzilli

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Abstract

Objective: Body weight-related insulin resistance probably plays a role in progression to type 1 diabetes, but has an uncertain impact following diagnosis. In this study, we investigated whether BMI measured at diagnosis was an independent predictor of C-peptide decline 1-year post-diagnosis. Design: Multicentre longitudinal study carried out at diagnosis and up to 1-year follow-up. Methods: Data on C-peptide were collected from seven diabetes centres in Europe. Patients were grouped according to age at diagnosis (<5 years, n=126; >5 years <10 years, n=295; >10 years <18 years, n=421; >18 years, n=410). Linear regression was used to investigate whether BMI was an independent predictor of change in fasting C-peptide over 1 year. Models were additionally adjusted for baseline insulin dose and HbA1c. Results: In individuals diagnosed between 0 and 5 years, 5 and 10 years and those diagnosed >18 years, we found no association between BMI and C-peptide decline. In patients aged 10-18 years, higher BMI at baseline was associated with a greater decline in fasting C-peptide over 1 year with a decrease (β 95% CI; P value) of 0.025 (0.010, 0.041) nM/kg per m2 higher baseline BMI (P=0.001). This association remained significant after adjusting for gender and differences in HbA1c and insulin dose (β=0.026, 95% CI=0.0097, 0.042; P=0.002). Conclusions: These observations indicate that increased body weight and increased insulin demand are associated with more rapid disease progression after diagnosis of type 1 diabetes in an age group 10-18 years. This should be considered in studies of β-cell function in type 1 diabetes.

Original languageEnglish
Pages (from-to)107-113
Number of pages7
JournalEuropean journal of endocrinology
Volume172
Issue number2
DOIs
Publication statusPublished - Feb 1 2015

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ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Lauria, A., Barker, A., Schloot, N., Hosszufalusi, N., Ludvigsson, J., Mathieu, C., Mauricio, D., Nordwall, M., Van Der Schueren, B., Mandrup-Poulsen, T., Scherbaum, W. A., Weets, I., Gorus, F. K., Wareham, N., Leslie, R. D., & Pozzilli, P. (2015). BMI is an important driver of β-cell loss in type 1 diabetes upon diagnosis in 10 to 18-year-old children. European journal of endocrinology, 172(2), 107-113. https://doi.org/10.1530/EJE-14-0522