obesity Linked to increased risk in adolescence Type 1 diabetes New studies suggest that it develops in adulthood.
These new data, tracked by Israeli recruits for more than a decade, suggest that obesity may play a role in causing type 1 diabetes as well as type 1. diabetes. Type 2 diabetes..
The incidence of type 1 diabetes has increased by about 2% to 3% each year in recent decades, for unknown reasons. This study is the first study to investigate the role of obesity in adolescence and type 1 diabetes in young adults, and also the first study to investigate the problem of using antibody status as part of the criteria for type 1 diagnosis.
The findings were reported at the American Diabetes Association’s annual science session by Dr. Gilad Twig, MD, a professor of medicine at the Sheva Medical Center in Telhashomer, Israel. “For people who are at high risk of developing type 1 diabetes, these results emphasize the importance of maintaining a normal weight,” he said in an interview. He said this recommendation applies to everyone, but “here it’s becoming more accurate for the population. It’s more individualized in the sense that it can be particularly useful.” rice field.
In an interview, Dr. Naveed Sattar, a professor and honorary consultant in cardiovascular science and medicine at the University of Glasgow, said, “If you are too heavy, it will be difficult to make a pancreas.” Insulin To keep sugar normal. Therefore, if you are stressing your system and it is likely that your pancreas is no longer functioning, it will not function faster. “
Clinically, Satter said, “Lifestyle is associated with the risk of developing type 1 diabetes. Weights can vary.” [from type 2].. Genetics remains the main factor for type 1 diabetes, but if you have a family history of type 1 and have a high genetic potential, staying lean can minimize your risk. “
Research highlights that Type 1 is not always ‘boy‘
In addition to countering the long-standing belief that type 1 diabetes is primarily a condition of lean people and is unrelated to obesity, the data also show that type 1 diabetes is not necessarily “young” and is actually It reinforces a new perception that it often occurs in adulthood.
“Approximately half of all cases of type 1 diabetes develop after the age of 18. People consider it a childhood illness, but now 50% of cases occur in late adolescence. It’s starting to look like this, “says Twig.
Satter points to a British biobank study It shows that almost half of all cases of type 1 diabetes occur after the age of 30. “You can definitely get Type 1 in adulthood. It’s not uncommon.”
Direct correlations found elsewhere in healthy adolescents
A national retrospective cohort study included 1,426,362 17-year-olds (834,050 men and 592,312 women) who had been medically evaluated prior to military recruitment since January 1996 and were followed up to 2016. I did. At baseline, there was no history of glycemic abnormalities.
The data was linked to information on adult-onset type 1 diabetes in the Israeli National Diabetes Log. In total, 777 cases of type 1 diabetes were recorded during the study, at a rate of 4.9 per 100,000 person-years.
With a median follow-up of 11.2 years, the incidence of type 1 diabetes increased gradually across the BMI group from underweight to obesity, from 3.6 to 8.4 cases per 100,000 person-years.
After adjusting for gender, year of birth, age at study initiation, education, and cognitive ability, hazard ratios are 1.05 for the 50-74th percentile and 1.41 for the 75-84th percentile, based on the 5th-49th percentile of BMI. It was 1.54. 2.05 for overweight and obese people.
Incidence of type 1 diabetes increased by 35% for every 5 units of BMI (adjusted hazard ratio 1.35), and risk increased by 35% for each increase (1.25), both values ​​were significant. ..
Sensitivity analysis showed similar results for people without other chronic health conditions at baseline. Another analysis of 574,720 subjects for which autoantibody data was available to confirm the diagnosis of type 1 diabetes did not change the results.
Mechanism hypothesis
The mechanism of association is not clear, but it is published at the same time paper At Diabetologia, Twig and colleagues outline some hypotheses. One is about increasing evidence of associations between different autoimmune states. This indicates that elevated adipokines and cytokines in obesity may reduce self-tolerance by promoting inflammatory processes.
The authors cite data from a TrialNet Pathway to Prevention study of relatives of type 1 diabetic patients who are overweight and obese participants at high risk of islet autoantibody development. However, not all data support this discovery.
“Obesity is associated with several other autoimmune conditions, so it’s not a complete surprise that it may be associated with another condition,” Twig said.
Other possibilities are: Vitamin D Deficiency, high-fat diet, and changes in the gut microbiota.
And there is the “accelerator hypothesis”, which means that both type 1 diabetes and type 2 diabetes Insulin resistance Genetic background affecting beta cell loss rate and disease phenotype. Satter said the accelerator hypothesis “is perfectly reasonable to me. It may not have been seen 40 years ago when the difference in BMI in society was much smaller because the population is so obese. No, but I’m looking at more now. “
Twig has no disclosure. Sattar receives consultation or lecture fees from Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Hanmi Pharmaceutical, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer, Sanofi and diagnoses Roche through AstraZeneca, Boehringer Ingelheim, Novartis, and his institution.
This article was originally MDedge.comIs part of the Medscape Professional Network.
