Weight-Loss Practices and Weight-Related Issues Among Youth With Type 1 or Type 2 Diabetes
- Jean M. Lawrence, SCD, MPH, MSSA1,
- Angela D. Liese, PHD, MPH23,
- Lenna Liu, MD, MPH4,
- Dana Dabelea, MD, PHD5,
- Andrea Anderson, MS6,
- Giuseppina Imperatore, MD, PHD7 and
- Ronny Bell, PHD6
- 1Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
- 2Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- 3Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- 4Children's Hospital and Regional Medical Center, Seattle, Washington
- 5Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, Colorado
- 6Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- 7Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
- Corresponding author: Jean M. Lawrence, jean.m.lawrence{at}kp.org
Abstract
OBJECTIVE—The purpose of this study was to describe the weight-loss practices and weight-related issues reported by youth with diabetes, according to sex and diabetes type.
RESEARCH DESIGN AND METHODS—A total of 1,742 female and 1,615 male youth aged 10–21 years with type 1 or type 2 diabetes completed a SEARCH for Diabetes in Youth study visit during which height, weight, and A1C were measured. A survey assessed weight-related issues and weight-loss practices.
RESULTS—Although more common in youth with type 2 diabetes, youth with type 1 diabetes also reported weight-related concerns and had elevated BMI. Among youth who had ever tried to lose weight (n = 1,646), healthy weight-loss practices (diet [76.5%] and exercise [94.8%]) were the most common, whereas unhealthy practices (fasting [8.6%], using diet aids [7.5%], vomiting or laxative use [2.3%], and skipping insulin doses [4.2%]) were less common. In sex-specific multivariable models including age, race/ethnicity, diabetes type, BMI category, and glycemic control, obese females and overweight/obese males were more likely to report ever practicing any unhealthy weight-loss practice than normal-weight youth. These practices were associated with poor glycemic control for female but not male subjects. All unhealthy weight-loss practices except fasting were more common in female than in male subjects. Dieting, fasting, and using diet aids were all more common in youth with type 2 diabetes than in those with type 1 diabetes.
CONCLUSIONS—Given the prevalence of overweight and obesity among youth with type 1 or type 2 diabetes, health care professionals caring for youth with diabetes need to pay particular attention to identifying youth, particularly females, with unhealthy weight-loss practices.
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 22 September 2008.
The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted September 4, 2008.
- Received April 13, 2008.
- DIABETES CARE
