Bioelectrical impedance analysis of body composition in children and adolescents with type 1 diabetes: a prospective case–control study

Abstract: Children and adolescents with type 1 diabetes can have impaired body composition. The aim of this study was to assess and compare body composition and phase angle, a cellular health indicator, in young patients with diabetes and healthy peers using a dual-frequency bioelectrical impedance analysis. Moreover, the influence of physical activity, glycemic control, disease duration, insulin dose, and delivery mode on body composition were explored. This was a prospective case–control study conducted on 46 patients with diabetes and 92 healthy subjects matched on the basis of pubertal status. BIA-ACC® analyzer, a dual-frequency device, was used to perform bioelectrical impedance analysis, and fat mass index and percentages of fat mass, free fat mass, total water content, extracellular and intracellular water, as well as basal metabolic rate and phase angle, were assessed; in patients with diabetes, information about disease duration, glycated hemoglobin, time in range, time above range, time below range, total daily insulin dose, and insulin delivery mode were collected. Patients with diabetes showed lower phase angle than controls, and the median phase angle of patients with diabetes that practiced extracurricular physical activity was comparable to healthy subjects. No other body composition parameters differed between cases and controls. Longer disease duration and higher daily insulin dose were both correlated with higher basal metabolic rate and higher phase angle. Conclusion: Children and adolescents with good management of type 1 diabetes showed comparable body composition measurements but a lower phase angle to their healthy peers. Patients with diabetes practicing extracurricular physical activity had phase angle values comparable to healthy subjects.