Association between childhood obesity and subsequent Type 1 diabetes: a systematic review and meta-analysis

Diabet Med. 2011 Jan;28(1):10-8. doi: 10.1111/j.1464-5491.2010.03160.x.


Aims: To review and synthesize the published evidence on the possible association between childhood obesity and the subsequent risk of Type 1 diabetes.

Methods: The PubMed database was systematically searched for studies using childhood obesity, BMI or %weight-for-height as the exposure variable and subsequent Type 1 diabetes as the outcome. Studies were only included if assessment of obesity preceded the diagnosis of Type 1 diabetes.

Results: Eight case-control studies and one cohort study were included, comprising a total of 2658 cases. Of these nine studies, seven reported a significant association between childhood obesity, BMI or %weight-for-height and increased risk for Type 1 diabetes. Meta-analysis of the four studies that reported childhood obesity as a categorical exposure produced a pooled odds ratio of 2.03 (95% CI 1.46-2.80) for subsequent Type 1 diabetes; however, in those studies, age at obesity assessment varied from age 1 to 12 years. A dose-response relationship was supported by a continuous association between childhood BMI and subsequent Type 1 diabetes in a meta-analysis of five studies (pooled odds ratio 1.25 (95%CI 1.04-1.51) per 1 sd higher BMI).

Conclusion: There is overall evidence for an association between childhood obesity, or higher BMI, and increased risk of subsequent Type 1 diabetes. Several theories have been proposed for a causal relationship. Reduction in Type 1 diabetes should be considered as a potential additional benefit of preventing childhood obesity.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Age of Onset
  • Body Mass Index
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / etiology
  • Europe / epidemiology
  • Female
  • Humans
  • Male
  • Obesity / epidemiology*
  • Obesity / etiology
  • Prospective Studies
  • Risk Factors
  • United States / epidemiology