Overweight and obesity in adults with type 1 diabetes mellitus
DOI:
https://doi.org/10.47196/diab.v53i3.171Keywords:
type 1 diabetes mellitus, obesity, overweightAbstract
Introduction: while the traditional idea has been that patients with type 1 diabetes mellitus (DM1) are thin, the prevalence of overweight and obesity has increased in parallel with the general population. Intensive treatment reduced microvascular complications, but generated overinsulinization, hypoglycemia, defensive intake and weight gain, with coexistence of elements of the metabolic syndrome.
Objectives: to determine the frequency of overweight, obesity and the associated risk factors and degree of insulin resistance in patients with DM1.
Patients and methods: 414 DM1 ≥18 years, women 52%, age 34.8±13.9 years of 14 departments of the province of Mendoza were stratified according to BMI in normal weight N, overweight and obesity. The following were analyzed: age, physical activity (PA) ≥3 times/week, HbA1c, LDL-C <100 mg/dL, HBP, level of education and insulin sensitivity according to the estimated rate of glucose disposition (ERGD) per Williams formula.
Results: overweight (OW) presented 34.2% and obesity (O) 10%. Women presented a higher frequency of normal weight than men (62% vs 49%; p=0.01), lower frequency of OW (28% vs 41%; p=0.005) and without difference of O (10% vs 9.5%; p=0.87). There was an increase in OW/O with age (p<0.0001). The systolic blood pressure (SBP) ≥130 mmHg was more frequent in O (54%) than in OW (29%) and in normal weight (16%) (p<0.0001). The ERGD was 9.14±1.64 mg/kg/min in the normal weight, 7.62±1.67 mg/kg/min in the OW and 6.02±2.20 mg/kg/min in the O (p<0.0001). LDL-C ≤100 mg/dL was percentage more frequent in normal weight (61%) than in OW (51%) and in O (46%) without reaching significant difference (p=0.08). There were no significant differences between the three groups in HbA1c, PA ≥3 times/week or in the level of instruction.
Conclusions: the frequency of OW/O in adult DM1 (44.2%) is high and like recent observations. The increase is marked between 25-50 years. OW/O was strongly associated with hypertension and insulin resistance. Weight control should be a priority goal in people with DM1.
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