Disclosures: The authors report no relevant financial disclosures.
April 16, 2021
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Overweight compounds likelihood of type 1 diabetes for children with high genetic risk

Disclosures: The authors report no relevant financial disclosures.
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Children with a high genetic risk for developing type 1 diabetes are at an increased risk for the disease if they have overweight or obesity from age 2 to 10 years, according to trial data published in Diabetologia.

“Previous studies have shown that increased rate of weight gain was associated with the development of type 1 diabetes,” Anita M. Nucci, PhD, RD, LD, chair and associate professor in the department of nutrition at Georgia State University, and Suvi M. Virtanen, MD, PhD, professor at the Finnish Institute for Health and Welfare and Tampere University, Finland, told Healio. “Our results revealed that being overweight, using the standardized definition of the term, during childhood (aged 2 to 10 years) was associated with increased risk of developing type 1 diabetes and the risk of progression from multiple islet autoimmunity to type 1 diabetes.”

Diabetes child 2019
Source: Adobe Stock

Nucci, Virtanen and colleagues analyzed data collected in the Trial to Reduce IDDM in the Genetically at Risk (TRIGR), a type 1 diabetes prevention trial designed to determine whether weaning to a hydrolyzed infant formula reduced type 1 diabetes incidence in children with a first-degree relative with type 1 diabetes and increased genetic risk. Children with a high risk for developing type 1 diabetes from the U.S., Canada, Australia and 12 European countries were recruited from May 2002 to January 2007. Height and weight data were obtained from birth until the last participant reached age 10 years. Overweight was defined as a BMI of 25 kg/m2 or greater and obesity as a BMI of 30 kg/m2 or higher.

Anita M. Nucci
Suvi M. Virtanen

Of the 2,149 TRIGR participants in TRIGR, 14% developed islet autoimmunity and 8% developed type 1 diabetes. The median age for seroconversion to islet autoimmunity was 36.4 months, and the median age for type 1 diabetes onset was 71.5 months.

The proportion of participants with overweight increased from about 9% at age 2 years to 28% at age 10 years, and the percentage of children with obesity increased from about 1.5% at age 2 years to 9% at age 10 years. Annual growth measures, including weight z score, height z score, overweight and obesity, were not associated with the development of any islet autoimmunity.

In time-varying models of growth from age 1 to 10 years, weight z score was associated with a higher risk for progression from multiple islet autoimmunity to type 1 diabetes (HR = 1.53; 95% CI, 1.16-2.03; P = .003) and developing type 1 diabetes (HR = 1.43; 95% CI, 1.2-1.72; P < .001). Children with overweight had a higher risk for type 1 diabetes onset compared with those with normal weight in a time-varying model (HR = 2.39; 95% CI, 1.46-3.92; P < .001).

At age 3 years, weight z score was associated with an increased risk for progressing from multiple islet autoimmunity to type 1 diabetes (HR = 1.48; 95% CI, 1.13-1.92; P = .004). There was also an increased risk for progression from multiple islet autoimmunity to type 1 diabetes at age 3 years in children with overweight (HR = 3.61; 95% CI, 1.73-7.54; P < .001) and obesity (HR = 18.88; 95% CI, 4.27-83.45; P < .001).

The researchers said the findings reveal the importance of monitoring weight for children at high genetic risk for type 1 diabetes.

“The study results provide practitioners with more evidence to support the implementation of weight-management strategies for children at risk of type 1 diabetes,” Nucci and Virtanen said. “We suggest that future studies examine the effect of weight-management strategies on mitigating these outcomes.”

For more information:

Anita M. Nucci, PhD, RD, LD, can be reached at anucci@gsu.edu.

Suvi M. Virtanen, MD, PhD, can be reached at suvi.virtanen@tuni.fi.