SAT-222 - BMI Patterns in Adolescents with Type 1 Diabetes at A Large, Urban Diabetes Center

Objectives:
To describe BMI patterns in adolescents with type 1 diabetes (T1D) treated at a large urban diabetes center and to investigate the association between glycemic control and BMI, race, and ethnicity.

Methods:
Retrospective chart review of 333 adolescents (13 years to 17 years 11 months) who have had T1D for at least 1 year and were seen between 2022-2024 at the Naomi Berrie Diabetes Center in New York. Demographic data, insurance type, BMI percentile, hemoglobin A1C (A1C) were collected. We used Fischer’s exact tests and Kruskal-Wallis rank sum tests to compare data.

Results:
This cohort was 52% male with median age of 15.3 years (14.3, 16.4), median duration of T1D of 7.4 years (4.0, 10.8), and median A1C of 7.5% (6.9, 8.4). 38% had public insurance. 25% Hispanic, 74% white and 12% Black.
63% had a BMI between the 5th-85th percentile (average), 23% had a BMI between the 85th-95th percentile (overweight) and 14% had a BMI greater than the 95th percentile (obese). Median BMI percentile was higher in those on insulin pumps with automated insulin delivery compared to those on multiple daily injections (78.6 percentile [60.6, 90.3] vs. 66.9 percentile [39.8, 88.5]). Median A1C was significantly higher among those with obese BMI (8.3% [7.4,8.9]) compared to those with an average (7.4% [6.8,8.4]) or overweight BMI (7.4% [6.9,8.0]) (p=0.005). There were no significant differences in A1C between females and males when stratified by sex and BMI.
When stratified by race and BMI, A1C was statistically significantly higher for Black teenagers (8.5% [7.2, 8.9]) than white teenagers (7.2% [6.6, 7.9]) with an average BMI (p < 0.001). However, in individuals with overweight and obese BMI, there were clinical but not statistical differences between A1C across racial groups.
Similarly, when stratified by ethnicity and BMI, A1C was significantly higher for Hispanic than non-Hispanic teenagers with average BMI (8.1% [7.3, 8.6] and 7.2% [6.6, 7.9] for Hispanic and non-Hispanic, respectively) and those with overweight BMI (8.4% [7.7, 8.4] and 7.2% [6.6, 7.6] for Hispanic and non-Hispanic, respectively) (p < 0.001). Among those with obese BMI, the A1C pattern reversed with Hispanic teenagers having a clinically significantly lower A1C than non-Hispanic teenagers.

Conclusions:
A1C were generally higher in those with an obese BMI and in Black and Hispanic adolescents, highlighting the need for targeted interventions to improve outcomes in these populations.

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