MONTREAL — At the onset of autoimmune diabetes, nearly half of African American children and almost one in five white children seen at Children's Hospital of Pittsburgh during 2004-2006 were overweight.
Those figures represent dramatic increases from the 1980s, when just 7% of African American and 3% of white children seen at the hospital were overweight at onset of autoimmune (type 1A) diabetes, Dr. Ingrid Libman reported in a poster presentation at the World Diabetes Congress.
Dr. Libman, a pediatric endocrinologist at the hospital, and her associates reported earlier that among children treated with insulin, the prevalence of overweight (body mass index of 85th percentile or greater) increased from 13% during 1979-1989 to 37% during 1990-1998 in white children, and from 22% to 55% during those two study periods in black children (Diabetes Care 2003;26:2871-5). In those with at least one antibody, the prevalence of overweight rose from 5% to 24%.
This time, they compared the period 1999-2006 (excluding 2003) with the previous two study periods. Data were available for 298 children out of 376 diagnosed with diabetes and treated with insulin during that time. Overall, the prevalence of overweight had more than tripled since 1979-1989, to 41%. Mean BMI percentile rose from 40.4 during 1979-1989 to 58.8 in 1990-1998 to 60.4 in 1999-2006.
Among 219 children for whom beta-cell antibody levels were available during all three periods, 173 (79%) were positive for at least one. This proportion was similar in each of the three time periods, Dr. Libman noted.
Of the 173 children with one or more antibodies, the proportions who were overweight rose from 5% to 25% to 31% during the three time periods. In contrast, the proportions overweight among the 46 with no antibodies—i.e., presumably with type 2 diabetes—were 46%, 70%, and 75%, respectively. The increase in overweight was more noticeable in the African American children with autoimmunity—from 7% to 38% to 46%, respectively, compared with 3%, 14%, and 19% of the white children.
Experts believe that weight excess plays an “accelerator” role in the ongoing increase in type 1A diabetes, Dr. Libman said in an interview.
Dr. Libman indicated that she had no conflicts of interest.