@article{3106916,
    title = "Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry",
    author = "Maffeis, C. and Birkebaek, N.H. and Konstantinova, M. and Schwandt, A. and Vazeou, A. and Casteels, K. and Jali, S. and Limbert, C. and Pundziute-Lycka, A. and Toth-Heyn, P. and de Beaufort, C. and Sumnik, Z. and Cherubini, V. and Svensson, J. and Pacaud, D. and Kanaka-Gantenbein, C. and Shalitin, S. and Bratina, N. and Hanas, R. and Alonso, G.T. and Poran, L. and Pereira, A.L. and Marigliano, M. and The SWEET Study Group",
    journal = "Pediatric Diabetes",
    year = "2018",
    volume = "19",
    number = "7",
    pages = "1211-1220",
    publisher = "Wiley-Blackwell Publishing Ltd",
    issn = "1399-543X, 1399-5448",
    doi = "10.1111/pedi.12730",
    keywords = "hemoglobin A1c;  insulin, adolescent;  adult;  age;  age distribution;  Article;  body mass;  child;  clinical assessment;  clinical feature;  cross-sectional study;  disease association;  disease course;  disease duration;  disease registry;  female;  human;  insulin dependent diabetes mellitus;  insulin treatment;  lipid storage;  major clinical study;  male;  obesity;  pediatrics;  prevalence;  priority journal;  prophylaxis;  sex difference;  therapy effect;  treatment outcome;  underweight;  clinical trial;  complication;  insulin dependent diabetes mellitus;  multicenter study;  obesity;  preschool child;  prevalence;  register;  underweight, Adolescent;  Child;  Child, Preschool;  Cross-Sectional Studies;  Diabetes Mellitus, Type 1;  Female;  Humans;  Male;  Obesity;  Prevalence;  Registries;  Thinness",
    abstract = "Objective: To assess the prevalence of underweight (UW), overweight (OW), and obesity in children and adolescents with type 1 diabetes (T1D). Methods: An international cross-sectional study including 23 026 T1D children (2-18 years, duration of diabetes ≥1 year) participating in the SWEET prospective, multicenter diabetes registry. Body mass index SD score (BMI-SDS) was calculated using the World Health Organization BMI charts. Children were categorized as UW (BMI-SDS < −2SD), OW (+1SD < BMI-SDS ≤ +2SD), and obese (OB) (BMI-SDS > +2SD). Hierarchic regression models were applied with adjustment for sex, age, and duration of diabetes. Results: The prevalence of UW, OW, and obesity was: 1.4%, 22.3%, and 7.3% in males and 0.6%, 27.2%, and 6.8% in females. Adjusted BMI-SDS was significantly higher in females than in males (mean ± SEM: 0.54 ± 0.05 vs 0.40 ± 0.05, P < 0.0001). In males, BMI-SDS significantly decreased by age (P < 0.0001) in the first three age categories 0.61 ± 0.06 (2 to <10 years), 0.47 ± 0.06 (10 to <13 years), 0.34 ± 0.05 (13 to <16 years). In females, BMI-SDS showed a U-shaped distribution by age (P < 0.0001): 0.54 ± 0.04 (2 to <10 years), 0.39 ± 0.04 (10 to <13 years), 0.55 ± 0.04 (13 to <16 years). BMI-SDS increased by diabetes duration (<2 years: 0.38 ± 0.05, 2 to <5 years: 0.44 ± 0.05, and ≥5 years: 0.50 ± 0.05, P < 0.0001). Treatment modality did not affect BMI-SDS. Adjusted HbA1c was significantly higher in females than in males (8.20% ± 0.10% vs 8.06% ± 0.10%, P < 0.0001). In both genders, the association between HbA1c and BMI-SDS was U-shaped with the highest HbA1c in the UW and obesity groups. Conclusions: The high rate of OW and obesity (31.8%) emphasize the need for developing further strategies to prevent and treat excess fat accumulation in T1D. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd"
}