Early rapid weight gain after T1DM diagnosis tied to non remission of diabetes

Rapid weight gain due to intensive insulin therapy in the early stages of T1diabetes diagnosis results in non-remission and increases the duration of partial remission. Insulin resistance caused by weight gain possibly caused Non-remission. 

The study was published in the Journal of Diabetes, on 12th August 2023. 

Immune-mediated beta-cell destruction causes T1 Diabetes leading to absolute insulin deficiency. Diagnosis of T1 DM is followed by partial clinical remission characterized by decreased insulin requirement and good glycemic control. Factors like residual beta-cell function and improvement in insulin sensitivity by reversal of glucose toxicity were thought to be related to partial remission (PR). Due to the uncertainty on the predictors and physiological factors causing the remission, researchers from the Department of Pediatrics, Division of Endocrinology Turkey have conducted a retrospective study to investigate the relationship between the rate of body weight gain after diagnosis of type 1 diabetes mellitus (T1DM) and other clinical factors for the development and duration of PR. 

By using insulin dose-adjusted glycosylated hemoglobin (HbA1c) values, children (2–16 years) with new-onset T1DM (n = 99) were grouped into remitters and non-remitters. By recording the laboratory and clinical data as well as daily insulin requirement per kilogram of body weight at diagnosis and each visit, PR duration was determined. Any changes in body mass index standard deviation score (BMI-SDS) were calculated by the auxological data that was collected every six months.

Findings: 

• There were 47 remitters (47.5%) and 52 (52.5%) non-remitters.
• The mean increase in BMI-SDS at the first 6 months of diagnosis was higher in the non-remitters than in the remitters (p = 0.04).
• A negative correlation was observed between the duration of PR and the change in BMI-SDS between 6 and 12 months after diagnosis.
• The predictors of remission were male sex, younger age, prepubertal status, and lower HbA1c.
• Among these male sex had the highest chance by multivariate regression.  

Thus, the study found that remission may be associated with less weight gain in children with T1DM and hence rapid weight gain shortens the duration of remission. 

Further reading: Early weight gain after diagnosis may have an impact on remission status in children with new-onset type 1 diabetes mellitus.  https://doi.org/10.1111/1753-0407.13455