Skip to main content
ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #284387
Title: Beta cell function and BMI in ethnically diverse children with newly diagnosed autoimmune type 1 diabetes

Author
item REDONDO, MARIA - Baylor College Of Medicine
item RODRIGUEZ, LUISA - Baylor College Of Medicine
item ESCALANTE, MIRNA - Texas Children'S Hospital
item SMITH, E - Children'S Nutrition Research Center (CNRC)
item HAYMOND, MOREY - Children'S Nutrition Research Center (CNRC)

Submitted to: Pediatric Diabetes
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/30/2012
Publication Date: 11/20/2012
Citation: Redondo, M.J., Rodriguez, L.M., Escalante, M., Smith, E.O., Haymond, M.W. 2012. Beta cell function and BMI in ethnically diverse children with newly diagnosed autoimmune type 1 diabetes. Pediatric Diabetes. 13(7):564-571.

Interpretive Summary: Since being overweight increases plasma insulin due to insulin resistance, we conducted a study to examine the relationship between body mass index (BMI) and the ability of children with type 1 diabetes (T1D) to make insulin. Thus we hypothesized that overweight or obese children presenting with type 1 diabetes will have greater insulin reserves. Children newly diagnosed with T1D with an ageaverage of 9.8 yr were studied. Aproximately, 22 percent of children were overweight or obese. Children with preserved insulin secretion were those who were overweight or obese compared to lean children. Pubertal development, race/ethnicity, blood sugar and number of anti-islet antibodies found in the plasma were not associated with decreased insulin secretion. Thus, obese and overweight children compared to lean children have greater insulin reserves at the time of diagnosis of onset of type 1 diabetes.

Technical Abstract: The objective of our study was to examine the relationship between BMI and beta-cell function at diagnosis of autoimmune type 1 diabetes (T1D) in a large group of ethnically diverse children. Cross-sectional analysis of 524 children (60.8% White, 19.5% Hispanic, 14.5% African-American, 5.2% other non-Hispanic; mean age = 9.8 yr [SD = 2.5]) with newly diagnosed autoimmune T1D. As much as 22.2% of children were overweight or obese. Median random serum C-peptide was 0.40 ng/mL (25th-75th percentiles = 0.3-0.8), with median glycemia of 366 mg/dL (25th-75th percentiles = 271-505). Median C-peptide was 0.3, 0.5, 0.7, and 0.85 ng/mL, respectively, in underweight, normal weight, overweight, and obese children (p < 0.0001, Kruskal-Wallis). In the final model (p < 0.0001), the odds of having preserved C-peptide (>/=0.6 ng/mL) were increased by 2.4-fold (95% CI = 1.2-4.9, p < 0.015) and 4.1-fold (1.9-8.5, p < 0.0001), respectively, in overweight and obese compared to lean children; 1.3-fold per each year of age; 2.5-fold in girls compared to boys; 4-fold in children who presented without, compared to with, diabetes ketoacidosis (DKA); and decreased by 21% for each point increase in HbA1c. Tanner stage, race/ethnicity, glycemia, and number of anti-islet antibodies expressed were not independently associated with preserved C-peptide. The association between BMI and C-peptide levels was significant in children with and without preserved C-peptide. Excluding patients who presented with DKA and/or using BMI obtained 5 wk after diagnosis did not alter the results. We concluded that obese and overweight children compared to lean children have greater beta-cell function at the onset of autoimmune T1D. Prospective studies on the relationships among BMI, beta-cell function, and progression to clinical T1D are warranted.