People with type 1 diabetes should be screened regularly for obesity and chronic kidney disease, according to a study, 'Obesity and Chronic Kidney Disease in US Adults With Type 1 and Type 2 Diabetes Mellitus', published in The Journal of Clinical Endocrinology & Metabolism.
"Our study shows that obesity rates in adults with type 1 diabetes are increasing and mirror the rates in the general adult population," said Dr Elizabeth Selvin, Johns Hopkins Bloomberg School of Public Health and John Hopkins University in Baltimore, Md. "Our research also highlights the high risk of kidney disease in people with type 1 diabetes. Kidney disease is often considered more common in people with type 2 diabetes, but our data shows adults with type 1 diabetes actually had a higher risk of kidney disease than those with type 2."
The researchers studied data from 4,060 people with type 1 diabetes and 135,458 people with type 2 diabetes from the Pennsylvania based Geisinger Health System between 2004-2018. People with type 1 diabetes were younger than type 2 diabetes (median age 39 vs 62 years). Obesity increased in type 1 diabetes over time (32.6% in 2004 to 36.8% in 2018), while obesity in type 2 diabetes was stable at ~60%.
The crude prevalence of low eGFR was higher in type 2 diabetes from than in type 1 diabetes in all years (eg, 30.6% vs 16.1% in 2018), but after adjusting for age differences, prevalence was higher in type 1 diabetes than type 2 diabetes from in all years (eg, 16.2% vs 9.3% in 2018). Obesity was associated with increased odds of low eGFR in type 1 diabetes and type 2 diabetes from.
The researchers said the results suggest the need for increased vigilance and assessment of kidney-protective medications in T1D.
"Our results highlight the need for interventions to prevent weight gain and end-stage kidney disease in people with type 1 diabetes," added Selvin.