Obesity Is More Prevalent in People with Type 1 Diabetes than Previously Thought

People with type 1 diabetes should be screened regularly for obesity and chronic kidney disease, according to a study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

Almost half of the adults in the U.S. have obesity, a chronic progressive disease characterized by an individual having an excess of body fat. Obesity is one of the leading causes of death in the U.S., and people with obesity are at an increased risk for many serious diseases and health conditions such as diabetes, heart, and liver disease. Obesity is a main risk factor for developing type 2 diabetes, but it has not been previously seen as a major complication in type 1 diabetes.

In type 1 diabetes, the body completely stops making insulin. In type 2 diabetes, the body produces insulin, but the cells do not respond to insulin as well as they should and later in the disease often do not make enough insulin. Type 2 diabetes is more likely to occur in people who are over the age of 40, overweight, and have a family history of diabetes, although more and more younger people are developing type 2 diabetes.

“Our study shows that obesity rates in adults with type 1 diabetes are increasing and mirror the rates in the general adult population,” says Elizabeth Selvin, PhD, M.P.H., of Johns Hopkins Bloomberg School of Public Health and John Hopkins University in Baltimore, Md. “Our research also highlights the high risk of kidney disease in people with type 1 diabetes. Kidney disease is often considered more common in people with type 2 diabetes, but our data shows adults with type 1 diabetes actually had a higher risk of kidney disease than those with type 2.”

The researchers studied data from 4,060 people with type 1 diabetes and 135,458 people with type 2 diabetes from the Pennsylvania-based Geisinger Health System between 2004-2018. They found 37% of people with type 1 diabetes had obesity, and the prevalence of kidney disease was higher in people with type 1 diabetes than those with type 2 after adjusting for age differences (16% vs. 9% in 2018).

“Our results highlight the need for interventions to prevent weight gain and end-stage kidney disease in people with type 1 diabetes,” Selvin says.

Other authors of the study include: Amelia Wallace, Jung-Im Shin and Morgan Grams of the Johns Hopkins Bloomberg School of Public Health and Johns Hopkins University; Alex Chang and Jodie Reider of Geisinger in Danville, Pa.; and Justin Echouffo Tcheugui of Johns Hopkins University.

The study received funding from the National Heart, Lung, and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases.

The manuscript, “Obesity and Chronic Kidney Disease in U.S. Adults with Type 1 and Type 2 Diabetes Mellitus,” was published online, ahead of print.