Body composition in adults with Type 1 diabetes at onset and during the first year of insulin therapy

• Published in: Diabetic medicine 2002-05, Vol.19 (5), p.417-423
• Main Authors: Rosenfalck, A. M., Almdal, T., Hilsted, J., Madsbad, S.
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; Adipose Tissue - anatomy & histology; Adolescent; Adult; Biological and medical sciences; Blood Glucose - metabolism; Body Composition; Body Mass Index; Body Water - physiology; Body Weight; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - physiopathology; Diabetes. Impaired glucose tolerance; DXA scanning; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Follow-Up Studies; Glycated Hemoglobin A - analysis; Humans; Hypoglycemic Agents - therapeutic use; Insulin - therapeutic use; Male; Medical sciences; nutrition; Time Factors; total body water; Type 1 diabetes
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1046/j.1464-5491.2002.00702.x

Aims To describe body composition in patients with Type 1 diabetes at diagnosis and during the first year after initiation of insulin therapy. Research design and methods In 10 (eight male and two female) newly onset Type 1 patients, age 31.5 ± 3.2 years (27–37 years) (sd and range), body mass index (BMI) 20.8 ± 1.6 (19.2–23.4) kg/m2, body composition was estimated by means of dual‐energy X‐ray absorptiometry (DXA) whole body scanning supplemented by estimation of total body water (TBW) (isotope dilution technique with 3H2O) at diagnosis and after 1, 3, 6 and 12 months of insulin therapy. Results During the first year after onset of diabetes body weight (BW) increased 4.3 ± 2.9 (0.1–8.3) kg (P = 0.0012) distributed as a 13.3% (1.6 kg) increase in total fat mass (FM) and 4.9% (2.5 kg) increase in lean body soft tissue mass (LBM). The self‐reported weight loss at onset was 6.3 ± 2.5 kg (1.5–10.0 kg). Compared with two reference populations the Metropolitan Life Insurance Co. and a healthy age and sex‐matched local DXA scanned group the initial body composition data demonstrated BW 6.2 kg below ideal weight and a significant reduction of the FM (25% or –0.87 sd), whereas LBM was within the expected range. Conclusions During the first year after onset of Type 1 diabetes the mean increase in BW is 6.5% with a 13.3% increase in FM and a 4.9% increase in LBM. Self‐reported data on premorbid BW suggest an approximately 10% reduction in BW at onset of Type 1 diabetes. Compared with a healthy reference population initial body composition data demonstrate a 25% reduction of the FM, whereas only a minor and non‐significant reduction in the LBM is encountered. These data indicate that uncontrolled diabetes is rather a fat catabolic state than, as previously believed, a protein catabolic state.