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Carlson NE, Horton KW, Hokanson JE, et al. Weight gain trajectories and obesity rates in intensive and conventional treatments of Type 1 diabetes from the DCCT compared to a control population without diabetes. Diabet Med. 2022;e14794doi: 10.1111/dme.14794.
Carlson, N. E., Horton, K. W., Hokanson, J. E., Cleary, P. A., Jacobs, D. R., Brunzell, J. D., Purnell, J. Q. (2022). Weight gain trajectories and obesity rates in intensive and conventional treatments of Type 1 diabetes from the DCCT compared to a control population without diabetes. Diabetic medicine : a journal of the British Diabetic Association, e14794. https://doi.org/10.1111/dme.14794
Carlson, Nichole E, et al. "Weight gain trajectories and obesity rates in intensive and conventional treatments of Type 1 diabetes from the DCCT compared to a control population without diabetes." Diabetic medicine : a journal of the British Diabetic Association vol. (2022): e14794. doi: https://doi.org/10.1111/dme.14794
Carlson NE, Horton KW, Hokanson JE, Cleary PA, Jacobs DR, Brunzell JD, Purnell JQ. Weight gain trajectories and obesity rates in intensive and conventional treatments of Type 1 diabetes from the DCCT compared to a control population without diabetes. Diabet Med. 2022 Jan 18;e14794. doi: 10.1111/dme.14794. Epub 2022 Jan 18. PMID: 35040196.
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Diabet Med. 2022 Jan 18;e14794. doi: 10.1111/dme.14794. Epub 2022 Jan 18.

Weight gain trajectories and obesity rates in intensive and conventional treatments of Type 1 diabetes from the DCCT compared to a control population without diabetes.

Diabetic medicine : a journal of the British Diabetic Association

Nichole E Carlson, Ken W Horton, John E Hokanson, Patricia A Cleary, David R Jacobs, John D Brunzell, Jonathan Q Purnell,

Affiliations

  1. Department of Biostatistics and Informatics, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.
  2. HQ USAFA/DFMS, USAF Academy, CO, USA.
  3. Department of Epidemiology, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.
  4. Biostatistics Center, George Washington University, Washington D.C.
  5. Division of Epidemiology and Community Health, University of Minnesota.
  6. Division of Metabolism, Endocrinology and Nutrition, University of Washington Seattle, WA, USA.
  7. Knight Cardiovascular Institute and Division of Endocrinology, Diabetes, and Clinical Nutrition, Department of Medicine, Oregon Health & Science University, Portland, OR, USA.

PMID: 35040196 DOI: 10.1111/dme.14794

Abstract

AIM: Obesity is a significant health issue for participants with Type 1 diabetes undergoing intensive diabetes management. The temporal pattern and factors associated with weight gain after treatment initiation remain poorly understood including how weight gain in participants with and without Type I diabetes compare. Our aim was to compare weight gain in those receiving intensive (INT) and conventional (CONV) Type 1 diabetes treatment to a population without diabetes.

METHODS: Participants included men and women 18 years and older in the Diabetes Control and Complications Trial (DCCT) randomized to INT (n=562) or CONV (n=568) and a prospective, observational cohort without diabetes from the Coronary Artery Development in Young Adults (CARDIA, controls) study (n=2446). Body mass index (BMI) trajectories and obesity prevalence were compared between groups and candidate metabolic and therapeutic moderators investigated.

RESULTS: Annual weight gain with INT peaked 1.3 years after initiation and was greater than both CONV and controls before and after this peak. Obesity prevalence with INT was lower than controls at baseline, was similar to controls at 2 years, and surpassed controls by 5 years. Obesity rates with CONV remained below controls at all time points. Greater annual weight gain in the DCCT was associated with lower haemoglobin A1c, higher insulin dose, and family history of type 2 diabetes.

CONCLUSIONS: Greater weight gain accompanying INT therapy occurs in two stages, leads to similar or greater obesity rates than controls after 2 years, is primarily modified by glucose control and family history, supportive of a therapeutic-genetic influence on weight trajectories.

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Keywords: Type 1 diabetes; haemoglobin A1c; insulin; intensive diabetes management; obesity

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