ESPE Abstracts

Objective: In this study, we aim ed to investigate the effect of body mass index on metabolic control and the relationship between daily insulin requirement and body mass index in children with newly diagnosed type 1 diabetes.

Materials and Methods: Between 17.11.2020 and 31.12.2021, 23 patients with newly diagnosed type 1 diabetes mellitus in the Pediatric Endocrinology Clinic and followed prospectively for the first year. Body weight sds, body mass index sds, height sds, waist and hip circumference, systolic and diastolic blood pressures, daily insulin doses, HbA1c levels at diagnosis and at 3, 6, 9 and 12 months after diagnosis.

Results: Of the total 23 patients, 8 (35%) were female and 15 (65%) were male. The median age at diagnosis was 105 (11-204) months. The most common presenting symptom was polyuria and polydipsia with 91.3%, followed by weight loss with 65.2%. One-year follow- up showed statistically significant increases in body weight sds, body mass index sds, waist and hip circumference measurements. No significant correlation was found between body mass index and body weight at diagnosis and age at diagnosis. The median HbA1c at diagnosis was 12.7% and there was a statistically significant decrease in HbA1c in the one-year follow-up. In the one-year follow-up, there was a statistically significant positive correlation between daily insulin dose and body weight sds and body mass index sds between the 6th and 12th months (P = 0.017, P = 0,037). There was a statistically significant relationship between waist and hip circumference and body mass index sds (P = 0.024, P = 0.002). No statistically significant correlation was found between daily insulin dose and waist and hip circumference and between HbA1c and waist and hip circumference.

Conclusion: There was a significant increase in body weight and body mass index especially in the 9th and 12th months according to the diagnosis, but HbA1c value decreased significantly in the 3rd, 6th, 9th and 12th months according to the diagnosis. Weight gain in the first year had no effect on HbA1c. While the HbA1c value was decreasing, the daily insulin dose decreased. However, while the daily insulin dose decreased in the 3rd and 6th months, it became similar to the diagnosis again in the 9th and 12th months when body weight increased significantly, and the increase in body weight increased the daily insulin dose. It was concluded that the nutritional plans of children with diabetes should be reviewed between six months and a year after diagnosis.