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. 2023 Dec;15(12):1011-1019.
doi: 10.1111/1753-0407.13455. Epub 2023 Aug 12.

Early weight gain after diagnosis may have an impact on remission status in children with new-onset type 1 diabetes mellitus

Dicle Canoruc Emet  1 , Hande Nur Karavar  1 , Onur Gozmen  1 , Arife Aslan Agyar  1 , Yağmur Ünsal  1 , Merve Canturk  1 , Pınar Cengiz  1 , Dogus Vuralli  1 , Z Alev Ozon  1 , E Nazlı Gonc  1
Affiliations

Early weight gain after diagnosis may have an impact on remission status in children with new-onset type 1 diabetes mellitus

Dicle Canoruc Emet et al. J Diabetes. 2023 Dec.

Abstract
in English, Chinese

Background: Residual beta-cell function and improvement in insulin sensitivity by reversal of glucose toxicity are two phenomena thought to be related to partial remission (PR). Body fat mass is the major determinant of insulin sensitivity. The aim of this study is to investigate the relationship between the rate of body weight gain after diagnosis of type 1 diabetes mellitus (T1DM) and other clinical factors for the development and duration of PR.

Methods: Children (2-16 years) with new-onset T1DM (n = 99) were grouped into remitters and non-remitters by using insulin dose-adjusted glycosylated hemoglobin (HbA1c) values. Laboratory and clinical data as well as daily insulin requirement per kilogram of body weight at diagnosis and each visit were recorded, and the duration of PR was determined. Changes in body mass index standard deviation score (BMI-SDS) were calculated by the auxological data collected every 6 months.

Results: There were 47 remitters (47.5%) and 52 (52.5%) non-remitters. The mean increase in BMI-SDS at the first 6 months of diagnosis was higher in the non-remitters than in the remitters (p = 0.04). Duration of PR was negatively correlated with the change in BMI-SDS between 6 and 12 months after diagnosis. Male sex, younger age, prepubertal status, and lower HbA1c were predictors of remission, among which male sex had the highest chance by multivariate regression.

Conclusions: Early rapid weight gain after diagnosis of T1DM may play a role in the lack of remission and shorter duration of PR. Interventions to prevent early rapid weight gain can maintain the development and prolongation of remission.

背景:残余β细胞功能和通过逆转葡萄糖毒性改善胰岛素敏感性被认为是与部分缓解(PR)相关的两种现象。体脂质量是胰岛素敏感性的主要决定因素。本研究旨在调查1型糖尿病(T1DM)诊断后体重增加率与其他临床因素之间的关系，以确定PR的发生和持续时间 方法:将新发T1DM儿童(2-16岁)(n=99)根据胰岛素剂量调整后的HbA1c值分为缓解组和非缓解组。记录实验室和临床数据以及诊断时和每次随访时每千克体重的每日胰岛素需求量，确定PR持续时间。以每六个月收集的生长发育数据，计算体重指数标准差评分(BMI-SDS)的变化 结果:47名患者(47.5%)病情缓解，52名患者(52.5%)病情未缓解。诊断后前6个月，病情未缓解患者的BMI-SDS平均增加值高于病情缓解患者(p=0.04)。PR持续时间与诊断后第6个月至第12个月BMI-SDS的变化呈负相关。多元回归分析显示男性、年轻、青春期前状态和较低的HbA1c是病情缓解的预测因素，其中男性的可能性最大 结论:T1DM诊断后早期体重快速增加可能在对难以缓解和PR持续时间较短起作用。预防早期体重快速增加的干预措施可能有助于维持和延长缓解.

Keywords: 1型糖尿病; BMI; remission; type 1 diabetes; weight change; 体重变化; 缓解.

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Conflict of interest statement

The authors declare no potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Early BMI‐SDS change in remitters versus non‐remitters.
FIGURE 2
FIGURE 2
Early BMI‐SDS change in remitters versus non‐remitters after adjusting for puberty and sex.
FIGURE 3
FIGURE 3
Correlation between BMI‐SDS2 and duration of PR.
See this image and copyright information in PMC

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