[Changes in nutritional state, metabolic control and treatment of type 1 diabetes in the last 20 years]

Abstract

Objective: The aim of this study is to describe changes in anthropometric characteristics, metabolic control, treatment and prevalence of overweight in diabetic children (DM1) from 2007 compared with another similar group from 1986.

Patients and methods: Observational retrospective study of two groups of diabetic children (n=90). The collection of variables has been made at two cross-sections, 1986 and 2007. The studied variables were: age, years of DM1, sex, weight, height, BMI (and their Z values), HbA(1c) and treatment with insulin (type, number of doses, IU/day and IU/kg/day).

Results: In 2007 group there is a significant increase in Z-weight and Z-BMI (P=.001) when compared with the 1986 group. There was a negative relationship between the years with DM1 and Z-height (P=.05) in the 1986 group. The value of HbA(1c) was lower in the 2007 group (P=.001), but the dose of insulin (IU/day and IU/kg/day) was similar in both groups. The number of daily doses of insulin was higher in the 2007 group (P<.001), the use of insulin analogues dominated overall. A statistically significant relationship between HbA(1c) and treatment with insulin (dose injections, insulin type) was not found. The prevalence of overweight (14.6% vs 2.4%) was significantly higher in the 2007 Group (P=.001).

Conclusions: The metabolic control (HbA(1c)) had improved and the use of multiple daily doses of insulin has been become the standard, but the prevalence of overweight has increased. We must monitor the emergence of insulin resistance and cardiovascular risk factors in this sensitive population to prevent early cardiovascular disease.