Grabia Monika, Markiewicz-Żukowska Renata
Department of Bromatology, Medical University of Białystok, Białystok, Poland.
Diabetes Ther. 2021 Jan;12(1):329-343. doi: 10.1007/s13300-020-00972-1. Epub 2020 Dec 8.
A significant increase in the incidence of overweight and obesity is observed among children and adolescents. This problem began to occur not only in healthy populations, but also among young diabetics. The aim of the study was to assess the nutritional status of children and adolescents with type 1 diabetes mellitus (T1DM) compared to those in a control group of healthy subjects as well as to determine the influence of the type of insulin therapy used.
The case-control study included 169 people aged 9-15 years. The study group (n = 85) consisted of Polish children with T1DM, and the control group (n = 84) consisted of healthy subjects. The assessment of the nutritional status included anthropometric measurements. Analysis of body composition was carried out by bioelectrical impedance analysis. To assess nutritional behavior a questionnaire was used. Approval was obtained from the ethics committee of the Medical University of Białystok (no. R-I-002/168/2017).
Median body mass index (BMI) value in the T1DM group was 19.2 kg/m and was statistically significantly (P < 0.05) higher than in the control group (17.8 kg/m). Normal BMI was found in 90% of the individuals in the CSII group, while in the MDI group it was only 61%. The percentage of fat mass was 19.1% in the T1DM group and 17.6% in the healthy group. The percentage of muscle mass was 36.1% and 34.5%, respectively. The abdominal obesity according to waist circumference (above 90th percentile) turned out to be statistically significant (P < 0.01) and occurred more often in adolescents with T1DM (27%), while in the healthy group it was 12%.
The healthy individuals as well as the majority of the children and adolescents with type 1 diabetes mellitus were well nourished. People using personal insulin pumps showed better nutritional status than those using insulin pens.
儿童和青少年中超重和肥胖的发生率显著增加。这一问题不仅出现在健康人群中,也出现在年轻糖尿病患者中。本研究的目的是评估1型糖尿病(T1DM)儿童和青少年与健康对照组相比的营养状况,并确定所用胰岛素治疗类型的影响。
病例对照研究纳入了169名9至15岁的人群。研究组(n = 85)由患有T1DM的波兰儿童组成,对照组(n = 84)由健康受试者组成。营养状况评估包括人体测量。通过生物电阻抗分析进行身体成分分析。使用问卷评估营养行为。获得了比亚韦斯托克医科大学伦理委员会的批准(编号R-I-002/168/2017)。
T1DM组的体重指数(BMI)中位数为19.2 kg/m²,在统计学上显著高于对照组(17.8 kg/m²)(P < 0.05)。持续皮下胰岛素输注(CSII)组中90%的个体BMI正常,而多次皮下注射胰岛素(MDI)组中仅为61%。T1DM组的脂肪量百分比为19.1%,健康组为17.6%。肌肉量百分比分别为36.1%和34.5%。根据腰围(高于第90百分位数)判断的腹部肥胖在统计学上具有显著性(P < 0.01),且在患有T1DM的青少年中更常见(27%),而在健康组中为12%。
健康个体以及大多数1型糖尿病儿童和青少年营养良好。使用个人胰岛素泵的人比使用胰岛素笔的人营养状况更好。