ESPE Abstracts

Introduction: Childhood overnutrition is a global challenge of public health. Both WHO and different countries have prepared BMI charts for pediatric population. Proper assessment of nutritional status is particularly important in children with type 1 diabetes (DM1). Due to Russian aggression, some Ukrainians with DM1 have to continue treatment in Poland.

Aim: to compare HbA1 concentrations and the incidence of overnutrition (overweight and obesity) with respect to WHO and national BMI reference charts between Ukrainian (UA) and Polish (PL) children with DM1 with respect to methods of insulin administration and glucose monitoring.

Methods: Retrospective analysis included 96 patients, age 7-18 years, with DM1: 32 UA and 64 PL, matched by age, sex and DM1 duration, by k-nearest neighbors algorithm. Overweight and obesity were defined as BMI exceeding 1 SD and 2 SD above the median for age (85^th and 97^th centile, respectively) and their incidence in UA and PL groups was calculated with respect to both WHO (2007) and national (Nyankovskyy et al. 2018 for UA, Kułaga et al. 2010 for PL) reference charts.

Results: Both personal insulin pumps and sensors (CGM or FGM) were significantly (P<0.05) more frequently used in PL (82.8%) than in UA (68.6%) children. There was no difference in HbA1c and nutritional status between PL and UA patients, except for significantly higher HbA1c and lower BMI SDS in UA children on pens than in these on pumps (8.6±2.1% vs. 7.0±1.1% and -0.25±1.01 vs 0.68±1.14, respectively). According to WHO charts 9.4% PL and 6.3% UA children were obese, while 17.2% PL and 21.9% UA overweight. With respect to the national charts, the incidence of overnutrition was significantly lower in PL (13.5%), while similar in UA (25.0%). Application of national charts for UA children, resulted in re-classifying 2 overweight girls as obese, while 2 overweight boys as normal. There was a difference between the children aged below and over 13 years in the incidence of overweight (13.0% vs. 24.0%) but not of obesity (8.7% vs. 8.0%) according to WHO charts.

Conclusions: There is a difference in the control of DM1 between UA but not PL children using pens and pumps. The incidence of overweight and obesity in children with DM1 exceeds values (centiles) defining the disorders. Discrepancies between the national charts cause difficulties in the correct assessment of nutritional status of children in case of cross-border migration.