Prevalence trends of obesity and overweight among 10-year-old children in western Sweden and relationship with parental body mass index.

AIM: To determine the regional prevalence, secular and family-related trends of obesity and overweight among 10-y-old children. METHODS: A cross-sectional study of 10-y-old children, born in 1990, was performed during September 2000 to June 2001 at school health centres in three communities in the western part of Sweden. Evaluation was performed in 6311 children, or 81% of the target population. Data from a cohort of children, born in 1974, who form the national growth charts, were available for comparison. RESULTS: The mean body mass index was 17.9 kg/m2 in 10-y-old children born in 1990 and 17.0 kg/m2 for 10-y-olds born in 1974 (p < 0.0001). Of the 10-y-old children in 2000-2001, born in 1990, 18% were overweight and 2.9 % obese, which corresponds to a twofold increase in presence of overweight and a fourfold increase in presence of obesity among 10-y-old children from 1984 to 2000. There was a significant correlation between parental and child body mass index. The prevalence of obesity and being overweight appeared to be higher in children whose parents did not participate in the study. CONCLUSION: During a 16-y period, from 1984 to 2000, a twofold increase in being overweight and a fourfold increase in obesity were seen among 10-y-old children in the western part of Sweden. Parental ponderosity or reluctance to participate in the study was related to a higher prevalence of being overweight or obese in the children. There is a need for the healthcare system to recognize the threats to the health of the population of this new "epidemic" and initiate preventive measures and treatment programmes.

Multiple insulin injection therapy using an insulin pen--who benefits? A clinical 3-year follow-up study of 100 type 1 and 51 type 2 diabetic patients.

The present study was undertaken with the aim of evaluating the effect of multiple insulin injection therapy with an insulin pen in a large population of type 1 and type 2 diabetes patients and to investigate which factors predict a favorable response to the therapy change. We included 100 type 1 and 51 type 2 patients with a minimum diabetes duration of 1 year who were followed for at least 3 years after changing from conventional insulin regimens to multiple insulin injection therapy with the pen. Both type 1 and type 2 patients were significantly improved with respect to metabolic control at 3 months. After 1 year type 1 patients were no longer significantly improved compared to baseline. In type 2 patients a significant improvement was sustained for a longer period but at 3 years HbA1c had reverted towards the baseline level. Both type 1 and type 2 patients experienced a significant increase in body weight. Baseline metabolic control was strongly and inversely related to subsequent decline in HbA1c in both type 1 and type 2 patients. Those with initial poor control had a sustained improvement throughout follow-up, whereas those with initial very good control deteriorated significantly. No sustained change was noted in those in intermediate control. In addition, in type 1 patients a high body mass index at baseline was a weak negative predictor for improvement. In type 2 patients a longer duration of diabetes was a favorable factor. Both type 1 and 2 patients in poor control may be expected to benefit from multiple injection therapy.