Insulin resistance in children and adolescents with type 1 diabetes mellitus: relation to obesity
- 1 March 2005
- journal article
- Published by Hindawi Limited in Pediatric Diabetes
- Vol. 6 (1), 5-12
- https://doi.org/10.1111/j.1399-543x.2005.00093.x
Abstract
Insulin resistance is well recognized both in type 1 diabetes mellitus (T1DM) and in obesity. Studies concerning the relation between insulin resistance and overweight in T1DM have not yet been carried out. Degree of overweight [standard deviation score-body mass index (SDS-BMI)] and daily insulin doses per weight (ID/kg), per body surface (ID/m2), and per ideal body weight (ID/IW) were recorded in 4124 children aged between 5 and 20 yr with a duration of T1DM of 4-5 yr and an adequate metabolic control [hemoglobin A1c (HbA1c) or = 1.0) and insulin-sensitive (ID/kg 1.9) and non-obese children. Multivariate linear regression analysis was conducted for the dependent variables ID/kg, ID/m2, and ID/IW, including age, gender, SDS-BMI, and HbA1c as independent variables. The 882 insulin-resistant children did not differ significantly (p = 0.447) with respect to SDS-BMI (median +0.38) compared to the 3242 insulin-sensitive children (median SDS-BMI +0.42). The ID/kg was significantly (p = 0.031) lower in the obese children compared to the non-obese children (median 0.80 vs. 0.83), while ID/m2 (median 31.0 vs. 26.2) and ID/IW (median 1.17 vs. 0.85) were significantly (p < 0.001) increased in the obese children. In multivariate linear regression analysis, SDS-BMI was significantly (p < 0.001) associated with an increase in ID/m2 and ID/IW and a decrease in ID/kg. T1DM children with insulin resistance based on ID/kg are not more overweight than insulin-sensitive children with T1DM. ID/m2 and ID/IW seem to reflect a better tool than ID/kg to describe the influence of overweight on insulin resistance in T1DM.Keywords
This publication has 37 references indexed in Scilit:
- Perzentile für den Body-mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher StichprobenMonatsschrift Kinderheilkunde, 2001
- The accelerator hypothesis: weight gain as the missing link between Type I and Type II diabetesDiabetologia, 2001
- Both insulin sensitivity and insulin clearance in children and young adults with Type I (insulin-dependent) diabetes vary with growth hormone concentrations and with ageDiabetologia, 2000
- Insulin doses in children using conventional therapy for insulin dependent diabetesDiabetes Research and Clinical Practice, 1995
- Epidemiological evidence for "double diabetes"The Lancet, 1991
- The pattern of basal and stimulated insulin responses to intravenous glucose in first degree relatives of Type 1 (insulin-dependent) diabetic children and unrelated adults aged 5 to 50 yearsDiabetologia, 1988
- Impaired Insulin Action in PubertyNew England Journal of Medicine, 1986
- Regulation of Splanchnic and Peripheral Glucose Uptake by Insulin and Hyperglycemia in ManDiabetes, 1983
- Insulin Resistance is a Prominent Feature of Insulin-dependent DiabetesDiabetes, 1982
- GLUCOSE TOLERANCE AND INSULIN INSENSITIVITYThe Lancet, 1968