Increasing secular trends in height and obesity in children with type 1 diabetes: JSGIT cohort

• Published in: PloS one Vol. 15; no. 11; p. e0242259
• Main Authors: Mochizuki, Mie, Ito, Yoshiya, Yokomichi, Hiroshi, Kikuchi, Toru, Soneda, Shun, Musha, Ikuma, Anzou, Makoto, Kobayashi, Koji, Matsuo, Kumihiro, Sugihara, Shigetaka, Sasaki, Nozomu, Matsuura, Nobuo, Amemiya, Shin
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 23.11.2020; Public Library of Science (PLoS)
• Subjects: Adolescent; Age groups; Anthropometry; Biology and Life Sciences; Blood Glucose - analysis; Body Height; Body mass; Body Mass Index; Body size; Cardiovascular diseases; Child; Childhood obesity; Children; Children & youth; Cohort Studies; Complications and side effects; Demographic aspects; Diabetes; Diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - diagnosis; Diabetes Mellitus, Type 1 - drug therapy; Drug dosages; Female; Forecasts and trends; Glucose; Glycated Hemoglobin A - analysis; Health aspects; Health risks; Hemoglobin; Humans; Hypoglycemia; Hypoglycemic Agents - therapeutic use; Insulin; Insulin - therapeutic use; Japan - epidemiology; Male; Medicine and Health Sciences; Obesity; Overweight; Pediatric Obesity - complications; Pediatric Obesity - diagnosis; Pediatric Obesity - epidemiology; Pediatric research; Pediatrics; Prevalence; Risk; Risk factors; Risk groups; Subgroups; Trends; Type 1 diabetes; Japan; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0242259

Recently, anthropometric indices in children with type 1 diabetes mellitus (T1DM) have begun to change. To examine secular trends in patients' anthropometric indices. Japanese children with T1DM from the 1995, 2000, 2008 and 2013 cohorts of The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes. We analysed serum haemoglobin A1c (HbA1c) levels, the incidence of severe hypoglycaemic events, the types and doses of insulin, height standard deviation scores (SDS), body mass index (BMI) percentiles compared with healthy Japanese children and obesity prevalence over time. We also stratified the patients according to glycaemic control levels of <58 mmol/mol (optimal), 58-75 mmol/mol (suboptimal) and ≥75 mmol/mol (high-risk). Data for 513-978 patients from each of the cohorts were analysed. The incidence of severe hypoglycaemic events decreased over time (from 21 to 4.8/100 patient-years), while the proportion of insulin analogue doses increased (14.6% to 98.6%). In addition, patient height SDS (-0.22 to +0.17), BMI percentile (52.1 to 58.7) and obesity prevalence (2.1% to 5.1%) increased. Height SDS increased in all of the glycaemic control subgroups, while BMI percentile and obesity prevalence increased in the suboptimal and high-risk groups. Since 1995, the average height of children with T1DM has increased in parallel with increasing insulin doses. Clinicians should be aware of increased BMI in these patients and the associated risk of developing cardiovascular disease in the future.