Sociodemographic inequities and use of hybrid closed-loop systems associated with obesity in youth with type 1 diabetes

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-02-09 DOI:10.1016/j.diabres.2025.112041

Svetlana Azova , Lori Laffel , Belinda S. Lennerz , Carter R. Petty , Joseph Wolfsdorf , Erinn T. Rhodes , Katharine Garvey

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Abstract

Aims

This study aimed to describe changes over time in rates of overweight and obesity and to identify factors associated with obesity in youth with type 1 diabetes.

Methods

We analyzed data from 7360 diabetes medical visits among 2242 youth with type 1 diabetes for ≥1 year followed at a pediatric, tertiary care, academic medical center between 2018 and 2023. Multivariable generalized estimating equations (GEE) analysis and conditional logistic regression (CLR), where each patient had both control (not obesity) and case (obesity) status, were conducted.

Results

Adjusted annual percentages of patients with obesity increased from 13.8 % in 2018 to 18.2 % in 2023 (P = 0.006); rates of overweight did not differ significantly over time. In multivariable GEE analysis, public insurance (P = 0.026), lower Child Opportunity Index score (P = 0.027), and use of hybridclosed-loop (HCL) systems (P = 0.023) were associated with obesity. In CLR, use of continuous glucose monitor and HCL systems and the sum of their effects (P = 0.002) were associated with obesity.

Conclusions

This study revealed increasing rates of obesity in children with type 1 diabetes and identified sociodemographic and diabetes care-related factors associated with obesity, highlighting targets for intervention to decrease future risk of cardiovascular complications.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.