Objective: To determine the trends in BMI z-score (z-BMI) and its correlation with insulin dose and HbA1c in children with new-onset type 1 diabetes (T1DM) from several Latin American centers over 3 years.

Methods: A retrospective chart review investigated the z-BMI trends in children aged 6 m-18 y with T1DM onset across 18 centers from 2019-2020 through 2023 in 5 Latin American countries: Argentina, Chile, Uruguay, Paraguay, and Peru. Anthropometric measures, insulin dose (U/kg/day), and Hb A1c (%) were collected at 3 months post-diagnosis and annually thereafter. Follow-up curves for z-BMI, HbA1c, and insulin dose were generated using the ANOVA method with repeated measures.

Results: A total of 421 children (48.9% females) aged 8.72 ± 3.75 years were included. The prevalence of obesity (OB) was 8.6%, overweight (OW) was 12.1%, and underweight (UW) was 10.0%. UW children increased their mean z-BMI by 2.28, whereas OW decreased by 0.29, and OB decreased by 0.94 at 3 years follow-up (P<0.01). Mean z-BMI values increased significantly over the 3-year follow-up compared with the initial year: year 0 (0.03) vs. year 1-2-3 (0.42, 0.43, 0.46). Concurrently, there was a significant increase in the insulin dose (U/kg/d) across each year: year 0 (0.56) vs. year 1 (0.62) vs. year 2 (0.70) vs. year 3 (0.74). Interestingly, the mean HbA1c in year 1 (8.52%) was significantly lower than in year 0 (8.98%), year 2 (8.74%), and year 3 (8.70%). The repeated measures model for the follow-up of the z-BMI over 3 years, adjusted for the differences in insulin dose and HbA1c (year 0 vs. year 3), showed a significant increase in z-BMI at the onset compared with years 1, 2, and 3, with insulin dose as a significant covariate.

Conclusion: We observed a significant increase in the z-BMI from T1DM onset through the 3-year follow-up in Latin American children, with insulin dose as a significant covariate. Although the insulin dose steadily increased, the impact on HbA1c (8.7%) does not appear to be close to optimal levels.

Disclosure

V. Hirschler: None. C. Molinari: None.

© 2024 by the American Diabetes Association
2024
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