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Journal

Birth weight influences the clinical phenotype and the metabolic control of patients with type 1 diabetes (T1D)

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Published:25th Mar 2020
Background: High birth weight has been related to an increased risk of type 1 diabetes (T1D), while suboptimal birth weight (both high and low) has been related to obesity, insulin resistance and type 2 diabetes (T2D). Insulin resistance, as a consequence of poor metabolic control, has been described in T1D patients. Aims of the study were to analyze the distribution of birth size for gestational age in a large group of T1D patients and to investigate the impact of birth weight on clinical phenotype. Methods: Six-hundred and two Caucasian T1D patients were evaluated. Small for gestational age (SGA) and large of gestational age (LGA) were defined as birth weight <3rd percentile or>97th percentile for gestational age, respectively. Birth weights between 3rd and 97th were defined as appropriate for gestational age (AGA). The clinical characteristics of SGA, AGA and LGA were compared. Multivariable linear regression models were fitted in order to evaluate the independent effect of birth weight and the other covariates (age at T1D onset, gender, T1D duration) on different clinical outcomes (BMI, HbA1c%, insulin requirement, HDL cholesterol, triglycerides). Results: Thirteen subjects (2.16%) were SGA, 39 (6.48%) were LGA. Daily insulin requirement (U/kg/day) was significantly higher in SGA, while BMI and HbA1c% were increased in LGA. Multivariable linear regression showed a significant negative impact of birth weight on daily insulin requirement (p <0.001). conclusions: suboptimal birth weight (both high and low) in t1d patients seems to be associated with clinical characteristics suggestive of insulin resistance.>

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