Obesity and Overweight Endanger Slim Diabetes type 1 Patients

The World Health Organization global report on diabetes, and recently updated facts sheet, estimate an increase of the number of people with diabetes (1, 2). A global projection for the year 2000 and projections for 2030 predict that the diabetes prevalence might rise from 171 million in 2000 to 366 million in 2030 (3). Risk factor-based projection models associating diabetes mellitus and taking into account the projected trends for overweight and obesity predict a concerning scenario (4, 5).

The type 1 diabetes (T1D), insulin-dependent, childhood-onset, or slim diabetes, is characterized by deficient insulin production and requires daily administration of insulin (6, 7). The cause of T1D is not known and currently it is not preventable. As for type 2 diabetes (T2D) patients, not insulin-dependent, and also known as adult-diabetes, comprises the majority of the people with diabetes, and it is mostly the result of overweight and lack of physical activity (8). T1D is the most common form of diabetes with an early onset, it accounts for approximately two-thirds of new diagnoses of diabetes in patients ≤19 years of age in the United States, but this association to a young and slim population is starting to change (9).

Patients with T1D currently present a fast increasing rate of obesity when compared to the general population (10). Approximately 50% of those patients with T1D suffer from overweight or are obese (11). This new tendency reflects a dangerous trend requiring a strict weight management and health control.

Assessing the best strategy to control T1D and prevent its inherent weight gain is imperative. The health burden is reaching concerning levels, not only for the health of the patients, but also for the national health systems and has direct productivity levels implications. More active weight management strategies must be implemented to invert this perilous tendency.

References:

1 – Global Report on Diabetes. WHO;2016.

2 - Mathers CD and Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine 2006;3:11:e44.

3 - Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27:1047–1053.

4 - Ohinmaa A, Jacobs P, Simpson S, Johnson JA. The projection of prevalence and cost of diabetes in Canada: 2000 to 2016. Can J Diabetes 2004;28:1.

5 - Boyle JP, Honeycutt AA, Naravan KMV, Hoerger TJ, Geiss LS, et al. Projection of diabetes burden through 2050. Diabetes Care 2001;24:1936–1940.

6 - Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J. Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group. Diabetes Care 2000;23:1516.

7 – Bougnères P, Valleron AJ. Global epidemiology of type 1 diabetes in young adults and adults: a systematic review. BMC Public Health 2015;15:255.

8 - Fagot-Campagna A, Pettitt DJ, Engelgau MM, Burrows NR, Geiss LS, Valdez R, Beckles GL, Saaddine J, Gregg EW, Williamson DF, Narayan KM. Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. J Pediatr 2000;136:664.

9 - Lipton RB, Drum M, Burnet D, Rich B, Cooper A, Baumann E, Hagopian W. Obesity at the onset of diabetes in an ethnically diverse population of children: what does it mean for epidemiologists and clinicians? Pediatrics 2005;115:e553.

10 - Szadkowska A, Madej A, Ziolkowska K, Szymanska M, Jeziorny K, Mianowska B, et al. Gender and age-dependent effect of type 1 diabetes on obesity and altered body composition in young adults. Annals of Agricultural and Environmental Medicine: AAEM. 2015;22(1):124–128.

11 - SEARCH for Diabetes in Youth Study Group, Liese AD, D'Agostino RB Jr, et al. The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for Diabetes in Youth Study. Pediatrics 2006;118:1510.

12 – Magliano DJ, Martin VJ, Owen AJ, Zomer E, Liew D. The Productivity Burden of Diabetes at a Population Level. Diabetes Care 2018;Feb;dc172138.

Keywords: Type 1 diabetes, Obesity, Excess Body Weight, Weight management

#Type 1 diabetes #Obesity #Excess Body Weight #Weight management