Khadilkar Anuradha V, Oza Chirantap, Mondkar Shruti A, Khadilkar Vaman, Kanungo Alok, Sethi Bipin K, Kumar Km Prasanna, Tandon Nikhil, Rao P V, Kumar Surendra, Bandgar Tushar R, Raghupathy Palany
Department of Growth and Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, Odisha, India.
Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, Odisha, India.
Indian J Endocrinol Metab. 2023 May-Jun;27(3):216-222. doi: 10.4103/ijem.ijem_224_22. Epub 2023 Jun 26.
India has the highest number of prevalent type-1 diabetes (T1D) cases in the under-20-year age population. Data on the anthropometry of underprivileged Indian children with T1D are scarce. In economically disadvantaged countries like India, poor growth in patients with T1D is a major concern due to limited accessibility and affordability. Besides, due to the double burden of malnutrition, the prevalence of obesity is increasing mirroring the global trends, which may lead to the development of insulin resistance.
This study aims to assess the prevalence of malnutrition in Indian children and youth with T1D and to identify the determinants of short stature.
A registry-based cross-sectional analysis of data collected from various centres across India enrolled in the Changing Diabetes in Children (CDiC) programme.
We observed that 6.4% were undernourished (3.4% severe undernutrition) and 17.7% (overweight 13.2%) had combined overweight/obesity. 21.2% of participants had short stature (adjusted for mid-parental height) with 7.4% cases of familial short stature. Longer duration of illness and insulin requirement were significant positive predictors of short stature while glycaemic control, insulin regimen and mid-parental height did not have a significant relationship with short stature. Participants on basal-bolus regimen had significantly higher insulin requirements and better glycaemic control than the ones on mixed-split regimen.
We report that around one-fifth of children and youth with T1D were overweight/obese and around a fourth were stunted, especially those with longer duration of diabetes and higher insulin requirements. Close monitoring of anthropometric parameters is necessary for all children with T1D to optimize growth and nutrition.
在20岁以下人群中，印度的1型糖尿病（T1D）患病率最高。关于贫困的印度T1D儿童人体测量学的数据稀缺。在像印度这样经济处于劣势的国家，由于可及性和可承受性有限，T1D患者生长发育不良是一个主要问题。此外，由于营养不良的双重负担，肥胖患病率正呈全球趋势上升，这可能导致胰岛素抵抗的发展。
本研究旨在评估印度T1D儿童和青少年中营养不良的患病率，并确定身材矮小的决定因素。
对参与“儿童糖尿病变化”（CDiC）项目的印度各中心收集的数据进行基于登记处的横断面分析。
我们观察到，6.4%的人营养不良（3.4%为严重营养不良），17.7%（超重占13.2%）存在超重/肥胖合并症。21.2%的参与者身材矮小（根据父母平均身高进行校正），其中7.4%为家族性身材矮小病例。病程较长和胰岛素需求量是身材矮小的显著正预测因素，而血糖控制、胰岛素治疗方案和父母平均身高与身材矮小无显著关系。与采用混合分剂量治疗方案的参与者相比，采用基础-餐时治疗方案的参与者胰岛素需求量显著更高，血糖控制更好。
我们报告称，约五分之一的T1D儿童和青少年超重/肥胖，约四分之一发育迟缓，尤其是糖尿病病程较长且胰岛素需求量较高的患者。对所有T1D儿童密切监测人体测量参数对于优化生长和营养状况很有必要。
