49-PUB: Body Mass Index, Dietary Intake, Diet Quality, and Pubertal Status of a Cohort of Children with Clinical Partial Remission of Type 1 Diabetes

Objective: Some children with type 1 diabetes (T1D) develop a transient recovery phase of beta cell function after diagnosis, also called partial remission (PR). Our aim is to describe the body mass index (BMI), dietary intake/quality, and glycemic metrics of children with clinical PR of T1D one year after diagnosis and explore associations with pubertal stage.

Methods: Children aged 1-17 yo with T1D diagnosis ≥1 year, at least 1 positive T1D antibody, receiving care at the Penn State Pediatric Diabetes Clinic and with PR (defined by an insulin dose-adjusted HbA_1C index [IDAA1C] ≤9 were included. Dietary intake was assessed by a single 24-hour recall (ASA24^®). Diet quality was assessed by the Healthy Eating Index (HEI-2015). Data were reported as median ± interquartile ranges (IQR), frequencies and percentages. Comparisons by pubertal stage were performed using the Fisher’s exact and Wilcoxon rank-sum tests (p=0.05).

Results: We identified 21 remitters: 62% M, 10.9 ± 3.96 yo, 71% White, 57% pump users, and 90% private insurance. T1D duration= 29 ± 18 months, HbA1C= 6.06 ± 0.53%, blood glucose= 137.9 ± 19.56 mg/dL, IDAA1C= 8.06 ± 0.94, and 95% were on CGMs. BMI at diagnosis vs. enrollment= 18.63 ± 4.54 kg/m² and 16.6 ± 2.92 kg/m²; and 62% were prepubertal at diagnosis. Most participants had healthier BMI at diagnosis vs. enrollment: 73.7% vs. 57.1% (p<0.05). Dietary intake = 1792 ± 347.2 kcal; carbohydrates (CHO) = 40.1 ± 8.2%, fats 41.9 ± 8.05%, protein 17.7 ± 5.8%, CHO intake = 188.4 ± 59.5 g/day. HEI-2015 = 58 ± 12.6. Pre-pubertal participants had higher rates of overweight/obesity at enrollment than at diagnosis (p=0.0135).

Conclusion: Most remitters had lower BMI percentiles at diagnosis, but those who were pre-pubertal increased their BMI significantly during the course of the disease.