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Obesity Linked to Type 1 Diabetes

Insulin Resistance May Explain Disease Increase in Younger Children
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Sept. 26, 2003 -- The obesity epidemic is widely blamed for a startling rise in the incidence of type 2 diabetes among children. Intriguing new research suggests it is also to blame for a similar increase in type 1 diabetes.

Though being overweight is the main risk factor for developing type 2 diabetes, it has not previously been thought to be a major factor in type 1 diabetes, once known as "juvenile-onset diabetes." Type 1 diabetes is considered to be a genetically driven autoimmune disorder in which the body destroys the insulin-producing cells that allow it to process glucose. In type 2 diabetes, the body produces insulin but is unable to use it properly, a condition known as insulin resistance.

In a hypothesis first made public two years ago, U.K. researcher Terry Wilkin, MD, and colleagues suggested that type 1 diabetes and type 2 diabetes are "one and the same disorder of insulin resistance set against different genetic backgrounds." To prove this, the researchers recently examined the relationship between body weight and age at diagnosis among a group of children with type 1 diabetes.

Accelerator Hypothesis

Ninety-four children between the ages of 1 and 16 were included in the study, and a strong correlation was seen between the children's age at the time diabetes was diagnosed and their weight. The findings are published in the October issue of the American Diabetes Association journal Diabetes Care.

"Basically, the age (at diagnosis) got younger and younger as the children got heavier and heavier," Wilkin tells WebMD. "This doesn't prove that insulin resistance drives type 1 diabetes, but it is some of the first direct evidence suggesting that it plays a role."

Wilkins says the observation could explain why more and more children are developing type 1 diabetes and why they are doing so at earlier ages than ever before. Kids who develop type 1 diabetes are genetically predisposed to get the disease, but being overweight accelerates the process, he argues.

Two other studies published in the same issue of Diabetes Care lend credibility to Wilkin's hypothesis. Researchers Ingrid M. Libman, MD, PhD, Dorothy J. Becker, MBBCH, and colleagues recorded the incidence of being overweight in children with type 1 diabetes treated at the Children's Hospital of Pittsburgh during two time periods.

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