Overweight status at diagnosis in Kuwaiti children with new-onset type 1 diabetes is associated with milder clinical presentation and lower HbA1c.

IntroductionThe coexistence of overweight/obesity and type 1 diabetes (T1D) may increase disease burden and management complexity. We assessed the prevalence of overweight/obesity in children newly diagnosed with T1D in Kuwait and characterized their baseline clinical, metabolic, and immunological features.Materials and methodsThis retrospective review analyzed medical records of children aged 14 years or younger diagnosed with T1D from 2017 to 2022. Data were obtained from the Childhood-Onset Diabetes electronic Registry (CODeR). Overweight/obesity was defined using WHO growth standards, and T1D diagnosis was confirmed based on the 2018 ISPAD guidelines.ResultsFrom 2,066 children with T1D in CODeR, 1,265 had BMI data and were included in the present study. Of these, 29.9% (378 children) were overweight/obese at diagnosis. Males were more likely to be overweight/obese than females (55.3% vs. 44.9%, p=0.001). Overweight/obese children were older at diagnosis compared to non-obese children (median age 9.3 vs. 7.3 years, respectively, p=0.0001). These children had a milder clinical presentation, with fewer cases of DKA, lower HbA1c, and lower triglycerides at diagnosis. After adjusting for age and gender, higher BMI z-scores were associated with lower HbA1c levels, reduced odds of DKA, and lower odds of celiac autoimmunity.ConclusionOverweight/obesity influence the presentation of type 1 diabetes in children, highlighting the need for early screening and targeted prevention. Longitudinal follow-up with genetic integration is warranted to better understand their relationship with disease progression and metabolic risk.