ESPE Abstracts

Introduction: Obesity may increase the risk of cardiovascular disease (CVD) in patients with type 1 diabetes (T1DM). Risk of CVD in girls with T1DM is suggested to be higher than boys, however data pertaining to risk of CVD in boys are limited. The aim of this study is to determine the prevalence of obesity and risk factors of CVD in adolescents with T1DM as well as the impact of gender on these parameters.

Methods: This is a retrospective analysis of 345 cases (190 girls) aged 10-18 years, with T1DM of at least 3 years, using intensive insulin therapy. Patients were divided into lean and overweight/obese groups according to body mass index (BMI). Risk factors for CVD (obesity, dyslipidemia, hypertension) were compared between groups, and impact of gender was also analyzed.

Results: Prevalence of overweight/obesity was 22.3% which was significantly higher in girls (26.8% vs 16.8%, P < 0.001). Age, duration of treatment, and HbA1c levels of two groups were similar. Daily dose of insulin was higher in overweight/obese group (1.4±0.3 U/kg vs 0.9±0.2 U/kg, P < 0.001). Mean LDL and TG levels were highest in overweight/obese girls, followed by overweight/obese boys, lean girls and lean boys, respectively (P = 0.002, and P = 0.003, respectively). Prevalence of LDL and TG elevation was similar between overweight/obese girls and boys, followed by lean girls and then lean boys (for LDL 74.5%, 69.2%, 36.7%, 23.3%, respectively, P = 0.008, and for TG 29.4%, 23.1%, 13.7%, 4.7%, respectively, P = 0.009). Mean HDL levels did not differ among groups. Prevalence of low HDL was similar in overweight/obese girls and boys which was higher than lean girls and boys (P = 0.006). Prevalence of hypertension was highest in overweight/obese girls followed by overweight/obese boys, and similar in lean boys and girls (P = 0.01).

Conclusion: Prevalence of obesity in this cohort is higher than the national prevalence of the same age. Overweight/obese girls with T1DM have the highest risk for CVD, followed by overweight/obese boys. Even lean girls have higher risk for CVD than lean boys. Control of weight during intensive insulin therapy is crucial in T1DM. Special attention should be paid to girls.