Risk of type 1 diabetes increases with BMI during adolescence


Zucker I, et al. 1263-P. Presented at American Diabetes Association Scientific Sessions; June 3-7, 2022; New Orleans (hybrid meeting).

Twig does not report any relevant financial information. Please see the study for relevant financial information from all other authors.

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NEW ORLEANS — The risk of adolescents developing type 1 diabetes increased with increasing BMI, according to data presented at the Scientific Sessions of the American Diabetes Association and simultaneously published in Diabetology.

“There were previous reports of the association between obesity and type 1 diabetes in previous cohorts that included mostly children,” Gilad Twig, MD, Ph.D., a resident of the department of internal medicine at Sheba Medical Center in Tel Aviv, Israel, told Healio. “We were somewhat surprised to see that the association persisted in perfectly healthy adolescents – aside from abnormal weight – with no apparent risk factors for type 1 diabetes.”

overweight child
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Twig and colleagues conducted a retrospective cohort study of adolescents aged 16 to 19 who underwent a pre-military conscription medical screening in Israel from January 1996 to December 2016. Participant data was linked to the Israeli National Registry diabetes. BMI was calculated using height and weight measured at baseline. Participants were placed in age- and gender-matched percentiles based on CDC criteria. Participants at the 85th to 94th percentile of BMI were considered overweight, and obesity was defined as the 95th percentile or greater.

There were 834,050 men and 592,312 women included in the study. Over a median follow-up of 11.2 years, there were 777 incident cases of type 1 diabetes over 15,819,750 person-years, for an incidence rate of 4.9 cases per 100,000 person-years.

The risk of type 1 diabetes increased progressively with higher BMI. In multivariate analysis, adolescents at the 75th to 84th percentile of BMI (adjusted HR = 1.41; 95% CI, 1.11-1.78), overweight (aHR = 1.54; 95% CI , 1.23-1.94) and obese (aHR = 2.05; 95% CI, 1.58-2.66), had an increased risk of type 1 diabetes compared to people in the fifth to 49th percentile of BMI.

“For obese adolescents, the risk of type 1 diabetes was approximately doubled,” Twig said. “It is important to remember that in our study we lumped all obese people into the group, regardless of the severity of obesity. Therefore, it is likely that for adolescents with more severe forms of obesity, the actual risk of developing type 1 diabetes is even higher.

Each 5-unit increase in BMI was associated with a 35% increased risk of developing type 1 diabetes (aHR = 1.35; 95% CI, 1.24-1.47) and each increase in One standard deviation of BMI increased the risk of developing type 1 diabetes by 25% (aHR=1.25; 95% CI, 1.17-1.32).

Twig said future research is planned to identify more risk factors for incident type 1 diabetes in the same cohort.

“We plan, in particular, to better identify the characteristics of adolescents in whom excess weight may have a greater role in the development of type 1 diabetes,” Twig said.


  • Zucker I, et al. Diabetology. 2022;doi:10.1007/s00125-022-05722-5.

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