ESPE Abstracts

Background: BMI in childhood is an indicator of future health.

Objective and hypotheses: To assess BMI distribution among children and young people with type 1 diabetes.

Method: The National Paediatric Diabetes Audit (NPDA) collates height and weight data on children and young people with diabetes in England and Wales. BMI centiles were calculated using the UK 1990 reference population. Underweight was defined as <5th centile, overweight 85th – 95th centile and obesity >95th centile.

Results: The 2013/2014 NPDA included data on 25 357 patients with type 1 diabetes. 1.6% Underweight, 57.5% healthy weight, 19.8% overweight, and 21.1% obese. Comparison to national data shows a higher prevalence of overweight and/or obesity in type 1 diabetes than in the general population. Living in more deprived areas are associated with obesity compared to the least deprived areas (odds ratio (OR) 1.71, 95% CI 1.54–1.89). Risk of obesity increased with age (OR 1.05, 95% CI 1.04–1.06/additional year) and being female (OR 1.26, 95% CI 1.17–1.34). A reduction in HbA1c of 1 mmol/mol was associated with an OR of 1.003 (95% CI 1.001–1.005). Duration of diabetes and ethnicity were not associated with obesity. Male gender (OR 1.95, 95% CI 1.53–2.47) and Asian ethnicity (OR cf. White ethnicity 2.14, 95% CI 1.45–3.16) were associated with increased risk of being underweight. An increase of 1 mmol/mol in HbA1c was associated with an OR 1.008 (95% CI 1.002–1.014). Deprivation, duration of diabetes and age were not associated with underweight.

Conclusion: There is a trend towards higher BMI in children and young people with type 1 diabetes. The trend towards obesity in girls and in the most deprived areas is recognised in the general population and suggests the importance of lifestyle factors. The significant OR of being obese with every 1 mmol/mol decrease in HbA1c suggests confounding influences of diabetes control which requires further evaluation.

Funding: This work was funded by the Healthcare Quality Improvement Partnership.