Overweight compounds likelihood of type 1 diabetes for child
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Children with a high genetic risk for developing type 1 diabetes are at an increased risk for the disease if they have overweight or obesity from age 2 to 10 years, according to trial data published in Diabetologia.

Researchers aimed to evaluate the relationship between childhood growth measures and risk of developing islet autoimmunity (IA) and type 1 diabetes in children with an affected first-degree relative and increased HLA-conferred risk. They hypothesized that being overweight or obese during childhood is associated with a greater risk of IA and type 1 diabetes.

Participants in a randomised infant feeding trial (N=2149) were measured at 12 month intervals for weight and length/height and followed for IA (at least one positive out of insulin autoantibodies, islet antigen-2 autoantibody, GAD autoantibody and zinc transporter 8 autoantibody) and development of type 1 diabetes from birth to 10–14 years. In this secondary analysis, Cox proportional hazard regression models were adjusted for birthweight and length z score, sex, HLA risk, maternal type 1 diabetes, mode of delivery and breastfeeding duration, and stratified by residence region (Australia, Canada, Northern Europe, Southern Europe, Central Europe and the USA).

Results:
-- In the Trial to Reduce IDDM in the Genetically at Risk (TRIGR) population, 305 (14.2%) developed IA and 172 (8%) developed type 1 diabetes.

-- The proportions of children overweight (including obese) and obese only were 28% and 9% at 10 years, respectively.

-- Annual growth measures were not associated with IA, but being overweight at 2–10 years of life was associated with a twofold increase in the development of type 1 diabetes and similarly with joint modelling.

Conclusively, in children at genetic risk of type 1 diabetes, being overweight at 2–10 years of age is associated with increased risk of progression from multiple IA to type 1 diabetes and with development of type 1 diabetes, but not with development of IA. Future studies should assess the impact of weight management strategies on these outcomes.

Source: https://link.springer.com/article/10.1007/s00125-020-05358-3
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