Obesity is one of the leading causes of death, especially in the United States. People with obesity are at an increased risk for serious diseases and health conditions such as diabetes, heart and liver disease. Even though, obesity is identified as a major risk factor for developing type 2 diabetes (T2D) it has not been previously seen as a major complication in type 1 diabetes (T1D). A recent study published in the ‘Journal of Clinical Endocrinology and Metabolism’ revealed that people with type 1 diabetes should be screened regularly for obesity and chronic kidney disease.

The study included all T1D and, for comparison, T2D in the Geisinger Health System from 2004 to 2018. The investigators evaluated the trends in obesity (body mass index ≥ 30 kg/m2), low estimated glomerular filtration rate (eGFR) (≤60 mL/min/1.73m2), and albuminuria (urine albumin-to-creatinine ratio ≥ 30 mg/g). Multivariable logistic regression is used to evaluate the independent association of obesity with CKD in 2018. From the results, it was observed an increase in obesity in T1D over time (32.6% in 2004 to 36.8% in 2018), while obesity in T2D was stable at ~60%. The crude prevalence of low eGFR was higher in T2D than in T1D in all years (eg, 30.6% vs 16.1% in 2018), but after adjusting for age differences, prevalence was higher in T1D than T2D in all years (eg, 16.2% vs 9.3% in 2018). Obesity was associated with increased odds of low eGFR in T1D [adjusted odds ratio (AOR) = 1.52, 95% CI 1.12-2.08] and T2D (AOR = 1.29, 95% CI 1.23-1.35).

According to the researchers obesity is increasing in people with T1D and is associated with increased risk of CKD. After accounting for age, the burden of CKD in T1D exceeded the burden in T2D, suggesting the need for increased vigilance and assessment of kidney-protective medications in T1D.

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