Noor, N, Akturk, H, Desimone, M, Basina, M, Rioles, N, Rompicherla, S, Haw, J, Golden, L, Ebekozien, O

Background: The primary objective of this U.S. based multi-center study was to determine if obesity is associated with an increase in A1c levels among adults with T1D. Additionally, we also examined patient and clinical profile across all BMI groups in the adult T1D population.

Methods: Electronic health record data from the T1D Exchange Quality Improvement (T1DX-QI) Collaborative for adult patients aged 21 years and older, between 2017-2021 was analyzed. BMI (kg/m2) was categorized into: Underweight (<18.5 kg/m2) , normal weight (18.5-24.9 kg/m2) , overweight (25.0-29.9 kg/m2) , obese (30.0-39.9 kg/m2) , and severely obese (≥ 40 kg/m2) . HbA1c levels were taken from patients’ most recent clinic visit. Multivariable regression analysis was used to examine the association between obesity and HbA1c levels.

Results: This analysis included 7,496 T1D adult patients, of which 3% were underweight, 42% normal weight, 33% overweight, 21% obese and 2% severely obese. Compared with normal weight people with T1D, the obese group were older (Mean (SD) , yrs: 36 (15) vs. 43 (15) ; p<0.001) , and less likely to use a CGM (72% vs. 66%; p<0.001) or insulin pump device CGM (63% vs. 57%; p<0.001) . Compared to normal weight individuals, obese people had higher HbA1c levels (B (SE) :0.17; p=0.002) adjusted for age, gender, insurance status and race/ethnicity.

Conclusion: In this large real-world study, we found obese adults were more likely to have higher A1c levels than normal weight adults with T1D.

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