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Unhealthy weight-loss practices not uncommon among young people with diabetes

Tuesday, December 16 2008 | Comments

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What's This? Clinicians should monitor young patients with diabetes, particularly females, for unhealthy weight-loss practices, which may have a negative effect on glycemic control, suggest researchers.

They studied weight-related issues, including weight-loss practices, among youth aged 10 to 21 years with type 1 or type 2 diabetes, analyzing data by sex and diabetes type. Participants were 1,742 females and 1,615 males, all of whom had completed a SEARCH for Diabetes in Youth study visit during which height, weight, and hemoglobin A1C were measured. The ongoing population-based SEARCH study includes young people with clinically diagnosed diabetes from 4 geographically defined populations, 4 American Indian populations, and several managed health care plans. The researchers surveyed participants to gain information about weight-related issues and weight-loss practices.

The investigators found that overweight and obesity were common in the study cohort, and 60% of females and 38% of males reported that they had tried to lose weight.

Unhealthy weight-loss practices (eg, fasting, using diet aids, vomiting or laxative use, and skipping insulin doses) were most common among females with type 2 diabetes (24.7%) who had an 82% increased likelihood of engaging in such unhealthy behavior relative to females with type 1 diabetes (odds ratio [OR], 1.82; 95% CI, 1.11-2.99). Unhealthy weight-loss practices were also reported among males, affecting 16.9% of those with type 2 diabetes and 2.7% of those with type 1 diabetes (OR for males with type 2 vs type 1 diabetes, 2.28; 95% CI, 1.09-4.75).

In addition, poor glycemic control was associated with unhealthy weight-loss practices among females (OR, 1.82; 95% CI, 1.23-2.70) but not among males.

"Given the high prevalence of overweight and obesity among type 2 diabetic youth, the increasing prevalence of these conditions in type 1 diabetic youth, and the pressures on some overweight and obese youth to lose weight, it is likely that approaches to weight management will not always be healthy ones," the authors concluded. "Such practices may have a negative effect on diabetes management, including glycemic control, a risk factor for future complications." (Lawrence JM, et al. Diabetes Care 2008;31:2251–2257.)

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