Body Composition of Children with Type 1 Diabetes: A 20-Year Single-Center Comparative Study.

BACKGROUND

Puberty in children with type 1 diabetes (T1D) is associated with increased insulin requirements, reduced insulin sensitivity, and changes in body composition.

OBJECTIVE

To evaluate body mass index (BMI) and body composition in children with T1D and compare the findings with data obtained 20 years earlier.

MATERIALS AND

METHODS

This retrospective comparative study included two historical cohorts of children with type 1 diabetes (T1D) examined at the same tertiary diabetes center 20 years apart. A total of 293 participants were included: 145 age-matched children assessed in 2003 and 148 children assessed in 2023 (mean age 12.15 ± 4.42 years). Body mass index (BMI), fat mass (FM), and fat-free mass (FFM) were analyzed using bioelectrical impedance analysis, and the effects of insulin therapy, continuous glucose monitoring (CGM), physical activity, and family history of obesity were evaluated.

RESULTS

Mean BMI in 2023 was 19.85 ± 4.47 kg/m2; 85.8% of participants had normal body weight, 6.0% were overweight, and 8.1% had obesity. Children with a family history of obesity had higher BMI values than those without such history (23.2 ± 6.0 vs. 19.4 ± 4.3 kg/m2; p < 0.05). The highest BMI values in both sexes were observed in patients with T1D duration of 5-10 years. Compared with 2003, contemporary prepubertal boys had higher BMI values. Higher FM percentages in girls compared with boys were preserved. CGM use was associated with lower HbA1c, lower insulin dose requirements, and lower BMI values (all p < 0.05).

CONCLUSIONS

Significant sex- and time-related differences in BMI and body composition were identified in children with T1D. CGM use was associated with better metabolic control and a more favorable body composition profile.