Introduction & Objective: Obesity is becoming a frequent comorbidity not only in patients with type 2 but also with type 1 diabetes mellitus (T1D). The aim of this study was to compare glucose control and prevalence of diabetes-associated complications in patients with T1D according to the presence of overweight or obesity.
Methods: Using data from the diabetes registry of a tertiary center, patients with T1D were stratified according to BMI into normal weight (BMI<25 kg/m2: n=831, age 40 (29-52) years (yr), T1D duration 20 (11-29) yr), overweight (BMI 25-30 kg/m2, n=741, age 46 (35-60) yr, T1D duration 23 (15-33) yr) and obese (BMI ≥30 kg/m2, n=366, age 48 (39-59) yr, T1D duration 24 (16-34) yr) and compared based on glucose control parameters (HbA1c, continuous glucose sensor metrics) and prevalence of diabetic complications and metabolic comorbidities.
Results: Compared with overweight and obese, patients with normal weight had a significantly lower HbA1c (56 (49-64) vs. 57 (51-65) vs. 60 (52-67), mmol/l, p<0.001), time above target range of 3.9-10 mmol/l(25 (16-39) vs. 28 (18-41) vs 31 (17-43)%, p=0.004) and average sensor glycemia (8.2 (7.4-9.3) vs. 8.4 (7.6-9.6) vs 8.7 (7.7-9.7) mmol/l, p<0.001). No significant difference was found in time in range or glycemic variability, while time below range was slightly lower in patients with obesity (3 (1-7) vs. 3 (1-7) vs. 3 (1-6), %, p=0.024). Higher BMI was associated with increased prevalence of arterial hypertension (32.7 vs. 46.4 vs. 65.6%, p=<0.001), dyslipidemia (38.4 vs. 54.1 vs. 70.7%, p=<0.001) and cardiovascular complications (6.7 vs. 10.1 vs. 12.4%, p= 0.004), as well as diabetic retinopathy (35.8 vs. 45.2 vs. 53.0%, p <0.001) and diabetic foot disease (4.6 vs. 5.5 vs. 9.7%, p= 0.003).
Conclusion: Our data indicate that an increase in BMI in patients with T1D is associated with worse glucose control and higher rate of diabetes complications and metabolic comorbidities.
L. Horváth: None. M. Mraz: None. D. Vávra: None. K. Sochorova: Consultant; Medtronic, Ypsomed AG. R. Bem: Speaker's Bureau; Abbott, A.import (Dexcom, Tandem), Medtronic. Research Support; Ministry of Health - Czech republic. Speaker's Bureau; Novo Nordisk. J. Klouckova: None. M. Haluzik: Advisory Panel; Sanofi, Novo Nordisk, Eli Lilly and Company, AstraZeneca, Bayer Inc., Johnson & Johnson Medical Devices Companies. Consultant; Merck & Co., Inc., Sanofi, Novo Nordisk, Eli Lilly and Company, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Johnson & Johnson Medical Devices Companies, Novatin. Research Support; Sanofi. Speaker's Bureau; Sanofi, Novo Nordisk.
Supported by the project CarDia (Programme EXCELES, Project No. LX22NPO5104); Funded by the European Union; Next Generation EU and Funded by Ministry of Health, Czech Republic; Conceptual Development of Research Organization ("Institute for Clinical and Experimental Medicine – IKEM, IN 00023001").
