24-h energy expenditure in people with type 1 diabetes: impact on equations for clinical estimation of energy expenditure

Elvis A Carnero; Karen D Corbin; Anna Casu; Daria Igudesman; Anika Bilal; Steven R Smith; Michael R Kosorok; David M Maahs; Elizabeth J Mayer-Davis; Richard E Pratley

doi:10.1038/s41430-024-01446-4

24-h energy expenditure in people with type 1 diabetes: impact on equations for clinical estimation of energy expenditure

Eur J Clin Nutr. 2024 May 14. doi: 10.1038/s41430-024-01446-4. Online ahead of print.

Authors

Affiliations

¹ AdventHealth Translational Research Institute, 301 E. Princeton St., Orlando, FL, 32804, USA. Elvis.Alvarezcarnero@adventhealth.com.
² AdventHealth Translational Research Institute, 301 E. Princeton St., Orlando, FL, 32804, USA.
³ Department of Biostatistics, University of North Carolina at Chapel Hill, 3101 McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA.
⁴ Department of Pediatrics, Division of Endocrinology, Stanford University, School of Medicine. 300 Pasteur Dr., Stanford, CA, 94305, USA.
⁵ Stanford Diabetes Research Center, Stanford, CA, 94305, USA.
⁶ Department of Epidemiology, Stanford University, School of Medicine, Stanford, CA, 94305, USA.
⁷ Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁸ School of Medicine, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA.

PMID: 38745052
DOI: 10.1038/s41430-024-01446-4

Abstract

Background/objectives: Type 1 diabetes (T1D) is associated with an increase in resting metabolic rate (RMR), but the impact of T1D on other components of 24-h energy expenditure (24-h EE) is not known. Also, there is a lack of equations to estimate 24-h EE in patients with T1D. The aims of this analysis were to compare 24-h EE and its components in young adults with T1D and healthy controls across the spectrum of body mass index (BMI) and derive T1D-specific equations from clinical variables.

Subjects/methods: Thirty-three young adults with T1D diagnosed ≥1 year prior and 33 healthy controls matched for sex, age and BMI were included in this analysis. We measured 24-h EE inside a whole room indirect calorimeter (WRIC) and body composition with dual x-ray absorptiometry.

Results: Participants with T1D had significantly higher 24-h EE than healthy controls (T1D = 2047 ± 23 kcal/day vs control= 1908 ± 23 kcal/day; P < 0.01). We derived equations to estimate 24-h EE with both body composition (fat free mass + fat mass) and anthropometric (weight + height) models, which provided high coefficients of determination (R² = 0.912 for both). A clinical model that did not incorporate spontaneous physical activity yielded high coefficients of determination as well (R² = 0.897 and R² = 0.880 for body composition and anthropometric models, respectively).

Conclusion: These results confirm that young adults with established T1D have increased 24-h EE relative to controls without T1D. The derived equations from clinically available variables can assist clinicians with energy prescriptions for weight management in patients with T1D.

Abstract

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