Adolescent obesity could lead to both T1 and T2 diabetes

Obesity in adolescence linked to T1D in adulthood.

Excessively high body mass index (BMI) in late adolescence has been linked to development of Type 1 diabetes, not just Type 2 diabetes, according to research presented at the American Diabetes Association 82nd Scientific Sessions in New Orleans, LA, published in Diabetologia and reported in Clinical; Advisor.

To study whether excessively high BMI in adolescence is associated with Type 1 diabetes, researchers at the Division of Endocrinology, Diabetes, and Metabolism at Sheba Medical Center in Israel, studied the 1.46m adolescents Israeli teenagers aged 16 to 19 years who were undergoing medical examination ahead of mandatory military service between January 1996 and December 2016. Data collected included height, weight, BMI, and blood work and were linked with information about adult-onset Type 1 diabetes in the Israeli National Diabetes Registry.

Overall, the researchers identified 777 incident cases of Type 1 diabetes during 11.2 years of follow-up (mean age at diagnosis, 25 years). Compared with adolescents classified as having optimal BMI, adolescents with obesity (≥95th percentile in weight based on Centers for Disease Control and Prevention criteria) had double the risk of developing Type 1 diabetes, while those with overweight (85th-95th percentile) had a 54% increased risk. A mildly increased risk (41%) was evident among adolescents with BMIs in the higher end of normal range (75th-84th percentile). For the entire BMI range, the authors reported that for “every 5 kg/m2 increase in weight, the adjusted risk to develop type 1 diabetes increases by 35%.”

“Additional factors associated with obesity may contribute to the development of autoimmunity, including vitamin D deficiency, consumption of a high-fat diet, and modulation of the gut microbiota,” the authors wrote. “Given that, in our cohort, there was an association between adolescent obesity and Type 1 diabetes, even when excluding those with pre-existing autoimmune conditions, additional factors may link obesity specifically to Type 1 diabetes.” In addition, the researchers noted increasing evidence of a shared genetic basis for diabetes and obesity.

“Our findings have public health implications” wrote the authors. “The prevalence of adolescent obesity is rising worldwide at an alarming rate, with dire projections for the near future. Currently it is estimated that nearly 60% of today’s US youth [ages 2-19 years] will develop obesity by age 35 years, most of them by adolescence, with half progressing to severe obesity. The current study projects that around 1 in 8 (12.8%) of the newly diagnosed cases of Type 1 diabetes in the study can be attributed to abnormally excessive weight at adolescence.”

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