Effect of obesity and excessive body fat on glycaemic control in paediatric type 1 diabetes.

Pian Pian Tee, Jeanne Sze Lyn Wong, Nalini M Selveindran, Janet Yeow Hua Hong
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Abstract

Objectives: Excessive adiposity is believed to contribute to insulin resistance, resulting in more complex metabolic outcomes and poorer glycaemic control. This study aimed to determine the prevalence of overweight/obese, excessive adiposity, and metabolic syndrome in type 1 diabetes mellitus (T1DM) children, who were from a relatively overweight/obese population, and to assess the effects on glycaemic control.

Methods: A cross-sectional study was conducted from November 2019 to August 2020 on T1DM children between 6 and 18 years old who attended the Paediatric Endocrine Clinic Putrajaya Hospital. Anthropometry and bioelectrical impedance analysis (Inbody 720) were measured to analyse their effects towards glycated haemoglobin (HbA1c) via SPSS 21.

Results: A total of 63 T1DM were recruited with an equal male-to-female ratio. The mean age was 12.4 ± 3.3 years old with a mean HbA1c of 9.8 ± 2.0%. The prevalence of overweight/obese and excessive body fat was 17.5 and 34.9%, respectively. Only 3 (6.8%) fulfilled the metabolic syndrome criteria. The waist circumference had a significant relationship with HbA1c. Every 10 cm increment of waist circumference was predicted to raise HbA1c by 0.8. The odds ratio of having abdominal obesity among T1DM with excessive body fat was 9.3 times.

Conclusions: Abdominal obesity is significantly associated with a poorer glycaemic control in T1DM children. Monitoring of waist circumference should be considered as part of the routine diabetic care.

肥胖和体脂过多对儿童1型糖尿病血糖控制的影响
目的:过度肥胖被认为有助于胰岛素抵抗,导致更复杂的代谢结果和更差的血糖控制。本研究旨在确定来自相对超重/肥胖人群的1型糖尿病(T1DM)儿童超重/肥胖、过度肥胖和代谢综合征的患病率,并评估其对血糖控制的影响。方法:2019年11月至2020年8月,对在布城医院儿科内分泌诊所就诊的6至18岁T1DM儿童进行了横断面研究。测量人体测量和生物电阻抗分析(Inbody 720),通过SPSS 21分析它们对糖化血红蛋白(HbA1c)的影响。结果:共招募63例T1DM患者,男女比例相等。平均年龄12.4±3.3岁,平均HbA1c为9.8±2.0%。超重/肥胖和体脂过多的患病率分别为17.5%和34.9%。只有3例(6.8%)符合代谢综合征标准。腰围与HbA1c有显著关系。预计腰围每增加10cm, HbA1c升高0.8。体脂过多的T1DM患者腹部肥胖的比值比为9.3倍。结论:腹部肥胖与T1DM儿童较差的血糖控制显著相关。监测腰围应被视为糖尿病常规护理的一部分。
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