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Insulin resistance in children and adolescents with type 1 diabetes mellitus: relation to obesity
Author(s) -
Reinehr Thomas,
Holl Reinhard W.,
Roth Christian L.,
Wiesel Thomas,
Stachow Rainer,
Wabitsch Martin,
Andler Werner
Publication year - 2005
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-543x.2005.00093.x
Subject(s) - medicine , overweight , insulin resistance , body mass index , obesity , endocrinology , diabetes mellitus , insulin , type 1 diabetes , bayesian multivariate linear regression , linear regression , machine learning , computer science
Background: 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. Methods: Degree of overweight [standard deviation score‐body mass index (SDS‐BMI)] and daily insulin doses per weight (ID/kg), per body surface (ID/m 2 ), 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) <8.0%]. SDS‐BMI was compared between insulin‐resistant (ID/kg ≥1.0) and insulin‐sensitive (ID/kg <1.0) children. The ID/kg, ID/m 2 , and ID/IW were compared between obese (SDS‐BMI >1.9) and non‐obese children. Multivariate linear regression analysis was conducted for the dependent variables ID/kg, ID/m 2 , and ID/IW, including age, gender, SDS‐BMI, and HbA1c as independent variables. Results: 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/m 2 (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/m 2 and ID/IW and a decrease in ID/kg. Conclusions: T1DM children with insulin resistance based on ID/kg are not more overweight than insulin‐sensitive children with T1DM. ID/m 2 and ID/IW seem to reflect a better tool than ID/kg to describe the influence of overweight on insulin resistance in T1DM.