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Erschienen in: European Journal of Pediatrics 7/2011

01.07.2011 | Original Paper

Overweight, obesity and features of metabolic syndrome in children with diabetes treated with insulin pump therapy

verfasst von: Włodzimierz Łuczyński, Agnieszka Szypowska, Barbara Głowińska-Olszewska, Artur Bossowski

Erschienen in: European Journal of Pediatrics | Ausgabe 7/2011

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Abstract

There has been no specific evaluation of atherogenic risk factors in children with type 1 diabetes mellitus (T1DM) treated with continuous subcutaneous insulin infusion (CSII). We, therefore, studied the prevalence of overweight/obesity and metabolic syndrome among these patients. Five hundred children with T1DM treated with CSII and multiple daily insulin (MDI) regimen were included in the study. Anthropometric data/physical examination, data concerning diabetes, and a lipid profile were assessed in this group, and compared with respect to treatment method (CSII vs. MDI). Almost one-third (30.2%) of the children were overweight/obese. The body mass index (BMI) values at the time of the present evaluation were significantly higher in comparison with the BMI values 3–6 months after the diagnosis. Dyslipidemia was recognized in 51.6%, hypertension in 4.8%, and the metabolic syndrome in 3.2%. of the subjects. The overweight/obese children differed from their normal-weight counterparts with respect to metabolic control, the incidence of hypertension, dyslipidemia, and metabolic syndrome. The girls showed higher prevalence of overweight/obesity and higher BMI values compared to the boys. The children treated with CSII had the same prevalence of overweight/obesity, but a lower incidence of dyslipidemia, and a better metabolic control compared to the children treated with MDI regimen. Our study shows a high prevalence of overweight/obesity and dyslipidemia in children with T1DM including those treated with an insulin pump.
Literatur
1.
Zurück zum Zitat Alemzadeh R, Berhe T, Wyatt DT (2005) Flexible insulin therapy with glargine insulin improved glycemic control and reduced severe hypoglycemia among preschool-aged children with type 1 diabetes mellitus. Pediatrics 115:1320–1324PubMedCrossRef Alemzadeh R, Berhe T, Wyatt DT (2005) Flexible insulin therapy with glargine insulin improved glycemic control and reduced severe hypoglycemia among preschool-aged children with type 1 diabetes mellitus. Pediatrics 115:1320–1324PubMedCrossRef
2.
Zurück zum Zitat Arcanjo CL, Piccirillo LJ, Machado IV et al (2005) Lipid profile and anthropometrical evaluation in type 1 diabetes. Arq Bras Endocrinol Metabol 49:951–958PubMedCrossRef Arcanjo CL, Piccirillo LJ, Machado IV et al (2005) Lipid profile and anthropometrical evaluation in type 1 diabetes. Arq Bras Endocrinol Metabol 49:951–958PubMedCrossRef
3.
Zurück zum Zitat Bergenstal RM, Tamborlane WV, Ahmann A et al (2010) Effectiveness of sensor-augmented insulin-pump therapy in type 1 diabetes. N Engl J Med 363:311–320PubMedCrossRef Bergenstal RM, Tamborlane WV, Ahmann A et al (2010) Effectiveness of sensor-augmented insulin-pump therapy in type 1 diabetes. N Engl J Med 363:311–320PubMedCrossRef
4.
Zurück zum Zitat Boland EA, Grey M, Oesterle A et al (1999) Continuous subcutaneous insulin infusion. A new way to lower risk of severe hypoglycemia, improve metabolic control and enhance coping in adolescents with type 1 diabetes. Diabetes Care 22:1779–1784PubMedCrossRef Boland EA, Grey M, Oesterle A et al (1999) Continuous subcutaneous insulin infusion. A new way to lower risk of severe hypoglycemia, improve metabolic control and enhance coping in adolescents with type 1 diabetes. Diabetes Care 22:1779–1784PubMedCrossRef
5.
Zurück zum Zitat Group TDR (1988) Weight gain associated with intensive therapy in the diabetes control and complications trial. The DCCT Research Group. Diabetes Care 11:567–573CrossRef Group TDR (1988) Weight gain associated with intensive therapy in the diabetes control and complications trial. The DCCT Research Group. Diabetes Care 11:567–573CrossRef
6.
Zurück zum Zitat Ingberg CM, Sarnblad S, Palmer M et al (2003) Body composition in adolescent girls with type 1 diabetes. Diabet Med 20:1005–1011PubMedCrossRef Ingberg CM, Sarnblad S, Palmer M et al (2003) Body composition in adolescent girls with type 1 diabetes. Diabet Med 20:1005–1011PubMedCrossRef
7.
Zurück zum Zitat Jeitler K, Horvath K, Berghold A et al (2008) Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Diabetologia 51:941–951PubMedCrossRef Jeitler K, Horvath K, Berghold A et al (2008) Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Diabetologia 51:941–951PubMedCrossRef
8.
Zurück zum Zitat Juliusson PB, Graue M, Wentzel-Larsen T, Sovik O (2006) The impact of continuous subcutaneous insulin infusion on health-related quality of life in children and adolescents with type 1 diabetes. Acta Paediatr 95:1481–1487PubMedCrossRef Juliusson PB, Graue M, Wentzel-Larsen T, Sovik O (2006) The impact of continuous subcutaneous insulin infusion on health-related quality of life in children and adolescents with type 1 diabetes. Acta Paediatr 95:1481–1487PubMedCrossRef
9.
Zurück zum Zitat Krishnan S, Short KR (2009) Prevalence and significance of cardiometabolic risk factors in children with type 1 diabetes. J Cardiometab Syndr 4:50–56PubMedCrossRef Krishnan S, Short KR (2009) Prevalence and significance of cardiometabolic risk factors in children with type 1 diabetes. J Cardiometab Syndr 4:50–56PubMedCrossRef
10.
Zurück zum Zitat Kułaga Z, Litwin M, Zajączkowska MM et al (2008) Porównanie wartości obwodów talii i bioder dzieci i młodzieży polskiej w wieku 7–18 lat z wartościami referencyjnymi dla oceny ryzyka sercowo-naczyniowego - wyniki wstępne projektu badawczego OLAF (PL0080). Stand Med 5:473–485 Kułaga Z, Litwin M, Zajączkowska MM et al (2008) Porównanie wartości obwodów talii i bioder dzieci i młodzieży polskiej w wieku 7–18 lat z wartościami referencyjnymi dla oceny ryzyka sercowo-naczyniowego - wyniki wstępne projektu badawczego OLAF (PL0080). Stand Med 5:473–485
11.
Zurück zum Zitat Lawrence JM, Liese AD, Liu L et al (2008) Weight-loss practices and weight-related issues among youth with type 1 or type 2 diabetes. Diabetes Care 31:2251–2257PubMedCrossRef Lawrence JM, Liese AD, Liu L et al (2008) Weight-loss practices and weight-related issues among youth with type 1 or type 2 diabetes. Diabetes Care 31:2251–2257PubMedCrossRef
12.
Zurück zum Zitat Libman IM, Pietropaolo M, Arslanian SA et al (2003) Changing prevalence of overweight children and adolescents at onset of insulin-treated diabetes. Diabetes Care 26:2871–2875PubMedCrossRef Libman IM, Pietropaolo M, Arslanian SA et al (2003) Changing prevalence of overweight children and adolescents at onset of insulin-treated diabetes. Diabetes Care 26:2871–2875PubMedCrossRef
13.
Zurück zum Zitat Maniatis AK, Klingensmith GJ, Slover RH et al (2001) Continuous subcutaneous insulin infusion therapy for children and adolescents: an option for routine diabetes care. Pediatrics 107:351–356PubMedCrossRef Maniatis AK, Klingensmith GJ, Slover RH et al (2001) Continuous subcutaneous insulin infusion therapy for children and adolescents: an option for routine diabetes care. Pediatrics 107:351–356PubMedCrossRef
14.
Zurück zum Zitat Monami M, Lamanna C, Marchionni N, Mannucci E (2010) Continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 1 diabetes: a meta-analysis. Acta Diabetol. In press Monami M, Lamanna C, Marchionni N, Mannucci E (2010) Continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 1 diabetes: a meta-analysis. Acta Diabetol. In press
15.
Zurück zum Zitat Mortensen HB, Hougaard P, Swift P et al (2009) New definition for the partial remission period in children and adolescents with type 1 diabetes. Diabetes Care 32:1384–1390PubMedCrossRef Mortensen HB, Hougaard P, Swift P et al (2009) New definition for the partial remission period in children and adolescents with type 1 diabetes. Diabetes Care 32:1384–1390PubMedCrossRef
16.
Zurück zum Zitat Newfield RS, Cohen D, Capparelli EV, Shragg P (2009) Rapid weight gain in children soon after diagnosis of type 1 diabetes: is there room for concern ? Pediatr Diabetes 10:310–315PubMedCrossRef Newfield RS, Cohen D, Capparelli EV, Shragg P (2009) Rapid weight gain in children soon after diagnosis of type 1 diabetes: is there room for concern ? Pediatr Diabetes 10:310–315PubMedCrossRef
17.
Zurück zum Zitat Patterson CC, Dahlquist GG, Gyürüs E et al (2009) Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. Lancet 373:2027–2033PubMedCrossRef Patterson CC, Dahlquist GG, Gyürüs E et al (2009) Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. Lancet 373:2027–2033PubMedCrossRef
18.
Zurück zum Zitat Pietilainen KH, Virtanen SM, Rissanen A et al (1995) Diet, obesity, and metabolic control in girls with insulin dependent diabetes mellitus. Arch Dis Child 73:398–402PubMedCrossRef Pietilainen KH, Virtanen SM, Rissanen A et al (1995) Diet, obesity, and metabolic control in girls with insulin dependent diabetes mellitus. Arch Dis Child 73:398–402PubMedCrossRef
19.
Zurück zum Zitat Reinehr T, Holl RW, Roth CL et al (2005) Insulin resistance in children and adolescents with type 1 diabetes mellitus: relation to obesity. Pediatr Diabetes 6:5–12PubMedCrossRef Reinehr T, Holl RW, Roth CL et al (2005) Insulin resistance in children and adolescents with type 1 diabetes mellitus: relation to obesity. Pediatr Diabetes 6:5–12PubMedCrossRef
20.
Zurück zum Zitat Russell-Jones D, Khan R (2007) Insulin-associated weight gain in diabetes - causes, effects and coping strategies. Diabetes Obes Metab 9:799–812PubMedCrossRef Russell-Jones D, Khan R (2007) Insulin-associated weight gain in diabetes - causes, effects and coping strategies. Diabetes Obes Metab 9:799–812PubMedCrossRef
21.
Zurück zum Zitat Schwab KO, Doerfer J, Hecker W et al (2006) Spectrum and prevalence of atherogenic risk factors in 27, 358 children, adolescents, and young adults with type 1 diabetes. Diabetes Care 29:218–225PubMedCrossRef Schwab KO, Doerfer J, Hecker W et al (2006) Spectrum and prevalence of atherogenic risk factors in 27, 358 children, adolescents, and young adults with type 1 diabetes. Diabetes Care 29:218–225PubMedCrossRef
22.
Zurück zum Zitat Silverstein J, Klingensmith G, Copeland K et al (2005) Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 28:186–212PubMedCrossRef Silverstein J, Klingensmith G, Copeland K et al (2005) Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 28:186–212PubMedCrossRef
23.
Zurück zum Zitat Strauss RS, Pollack HA (2001) Epidemic increase in childhood overweight, 1986–1998. JAMA 286:2845–2848PubMedCrossRef Strauss RS, Pollack HA (2001) Epidemic increase in childhood overweight, 1986–1998. JAMA 286:2845–2848PubMedCrossRef
24.
Zurück zum Zitat Szadkowska A, Pietrzak I, Szlawska J et al (2009) Abdominal obesity, metabolic syndrome in type 1 diabetic children and adolescents. Pediatr Endocrinol Diabetes Metab 15:233–239PubMed Szadkowska A, Pietrzak I, Szlawska J et al (2009) Abdominal obesity, metabolic syndrome in type 1 diabetic children and adolescents. Pediatr Endocrinol Diabetes Metab 15:233–239PubMed
25.
Zurück zum Zitat van Vliet M, van der Heyden JC, Diamant M et al (2010) Overweight is highly prevalent in children with type 1 diabetes and associates with cardiometabolic risk. J Pediatr 156:923–929PubMedCrossRef van Vliet M, van der Heyden JC, Diamant M et al (2010) Overweight is highly prevalent in children with type 1 diabetes and associates with cardiometabolic risk. J Pediatr 156:923–929PubMedCrossRef
26.
Zurück zum Zitat Williams KV, Erbey JR, Becker D, Orchard TJ (1999) Improved glycemic control reduces the impact of weight gain on cardiovascular risk factors in type 1 diabetes. The Epidemiolgy of Diabetes Complications Study. Diabetes Care 22:1084–1091PubMedCrossRef Williams KV, Erbey JR, Becker D, Orchard TJ (1999) Improved glycemic control reduces the impact of weight gain on cardiovascular risk factors in type 1 diabetes. The Epidemiolgy of Diabetes Complications Study. Diabetes Care 22:1084–1091PubMedCrossRef
27.
Zurück zum Zitat Zimmet P, Alberti KG, Kaufman F et al (2007) The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes 8:299–306PubMedCrossRef Zimmet P, Alberti KG, Kaufman F et al (2007) The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes 8:299–306PubMedCrossRef
Metadaten
Titel
Overweight, obesity and features of metabolic syndrome in children with diabetes treated with insulin pump therapy
verfasst von
Włodzimierz Łuczyński
Agnieszka Szypowska
Barbara Głowińska-Olszewska
Artur Bossowski
Publikationsdatum
01.07.2011
Verlag
Springer-Verlag
Erschienen in
European Journal of Pediatrics / Ausgabe 7/2011
Print ISSN: 0340-6199
Elektronische ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-010-1372-7

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