Increased Adiposity at Diagnosis in Younger Children With Type 1 Diabetes Does Not Persist

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Abstract
Increased adiposity, as measured by BMI, has been described in younger children at diagnosis of type 1 diabetes compared with older children (1–3) in support of the “accelerator hypothesis” (1). Australia has one of the highest rates of childhood obesity in the Western world, but a disproportionate increase in type 1 diabetes incidence has not been observed in young children (4), which is contrary to recent reports of other populations (5,6). We therefore sought to investigate whether anthropometric data at diagnosis from 1976 to 2004 support the accelerator hypothesis in our population. In addition to its potential contribution to type 1 diabetes etiology, the insulin resistance associated with increased adiposity places these children at greater risk of vascular disease (7–9). In a cross-sectional study of children with median diabetes duration of 3 years, we have previously found that those with the highest BMI SD score (SDS) were younger and had worse metabolic control (10). Hence, in this longitudinal study, we examined whether increased adiposity at diagnosis persisted in the youngest children after 5 years. The study group consisted of children and adolescents attending the diabetes outpatient and outreach clinics of the Royal Alexandra Hospital for Children in Sydney and rural New South Wales, Australia, from 1976 to 2004. To exclude the initial weight loss due to acute destabilization, only height, weight, and BMI available 1–3 months postdiagnosis were analyzed ( n = 960). In those diagnosed …