Bonhoure Anne, Lalanne-Mistrih Marie-Laure, Talbo Meryem, Boudreau Valérie, Messier Virginie, Bandini Aude, Secours Laurence, Fontaine Sonia, Brazeau Anne-Sophie, Rabasa-Lhoret Rémi
Montreal Clinical Research Institute, Montreal, Quebec, Canada.
Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
J Clin Transl Endocrinol. 2025 May 23;41:100400. doi: 10.1016/j.jcte.2025.100400. eCollection 2025 Sep.
The prevalence of overweight and obesity in people with type 1 diabetes has increased significantly, presenting additional psychosocial challenges that vary by gender. This study investigates the relationship between BMI and psychosocial outcomes in adult men and women with type 1 diabetes.
This cross-sectional analysis used data from people with type 1 diabetes in the BETTER registry, stratified by gender and categorized into BMI groups (<25, 25-29.9, ≥ 30 kg/m). Psychosocial outcomes included depression, diabetes distress, and stigmatization related to diabetes. One-way ANOVA assessed differences between BMI groups by gender. Multivariable logistic regression then analyzed gender differences within each BMI group, adjusting for age and HbA1c.
Among 1028 participants (66 % women, mean BMI 26.4 ± 5.1 kg/m, mean age 45.4 ± 15.0 years), 460 adults (45 %) had a BMI < 25, 356 (35 %) between 25-29.9, and 212 (21 %) ≥ 30 kg/m. Women in the ≥ 30 kg/m group, compared to the < 25 kg/m group, had more symptoms of depression, more drug prescriptions for depression/anxiety, and higher diabetes distress (p < 0.001 for all). In men, psychosocial outcomes did not differ significantly across BMI groups. Multivariable regression showed women were more likely than men to report prescriptions for depression/anxiety and high diabetes distress, particularly in the higher BMI groups.
In adults living with type 1 diabetes, higher BMI is associated with adverse psychosocial outcomes, particularly in women. Gender-specific interventions addressing mental health, stigma, and weight management could be beneficial to improve overall well-being.
1型糖尿病患者中超重和肥胖的患病率显著增加，带来了因性别而异的额外心理社会挑战。本研究调查1型糖尿病成年男性和女性的体重指数（BMI）与心理社会结局之间的关系。
本横断面分析使用了BETTER注册研究中1型糖尿病患者的数据，按性别分层并分为BMI组（<25、25 - 29.9、≥30kg/m²）。心理社会结局包括抑郁、糖尿病困扰以及与糖尿病相关的污名化。单向方差分析评估按性别划分的BMI组之间的差异。多变量逻辑回归随后分析每个BMI组内的性别差异，并对年龄和糖化血红蛋白（HbA1c）进行校正。
在1028名参与者中（66%为女性，平均BMI为26.4±5.1kg/m²，平均年龄45.4±15.0岁），460名成年人（45%）的BMI<25，356名（35%）在25 - 29.9之间，212名（21%）≥30kg/m²。与<25kg/m²组相比，≥30kg/m²组的女性有更多抑郁症状、更多治疗抑郁/焦虑的药物处方以及更高的糖尿病困扰（所有p<0.001）。在男性中，不同BMI组的心理社会结局无显著差异。多变量回归显示，女性比男性更有可能报告有抑郁/焦虑的处方以及高糖尿病困扰，尤其是在较高BMI组中。
在1型糖尿病成年患者中，较高的BMI与不良心理社会结局相关，尤其是在女性中。针对心理健康、污名化和体重管理的针对性别干预可能有助于改善整体健康状况。
