Obesity in people living with type 1 diabetes

Schueren, Bart Van der; Ellis, Darcy; Faradji, Raquel N.; Al-Ozairi, Ebaa; Rosen, Jonathan; Mathieu, Chantal

doi:10.1016/s2213-8587(21)00246-1

Cited by 76 publications

(58 citation statements)

References 89 publications

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“…Furthermore, females in our cohort were more at risk similar to other reports [32,33,35]. In all these studies, several factors have been associated with this risk of overweight/obesity in T1D as increased functional growth hormone (GH) secretion, longer disease duration, intensive insulin therapy in relation to pubertal insulin-resistance or flexible eating patterns, high insulin doses that could inhibit protein catabolism and slow basal metabolism or frequent snacking to avoid hypoglycemia [36,37]. However, only a few authors focused on dietary risk factors and even fewer on the MedDiet.…”

Section: Dietary Factors Associated With the Risk Of Obesitysupporting

confidence: 86%

Adherence to the Mediterranean Diet Is Associated with Better Metabolic Features in Youths with Type 1 Diabetes

et al. 2022

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Our aim was to evaluate adherence to the Mediterranean diet (MedDiet) among children and adolescents with type 1 diabetes (T1D) in relation to metabolic control. Adherence to the MedDiet was assessed with the Mediterranean Diet Quality Index (KIDMED)questionnaire and physical activity by the International Physical Activity Questionnaire for Adolescent (IPAQ-A) on 65 subjects (32 males, 9–18 years) with T1D. Clinical and metabolic evaluation was performed (standardized body mass index(BMI-SDS), hemoglobin A1C (HbA1c), continuous glucose monitoring metrics when present, blood pressure, lipid profile). Parental characteristics (age, body mass index (BMI), socio-economic status) were reported. The adherence to the MedDiet was poor in 12.3%, average in 58.6%, and high in 29.1% of the subjects. Furthermore, 23.4% of patients were overweight/obese. The most impacting factors on BMI-SDS were skipping breakfast and their father’s BMI. HbA1c and time in range % were positively associated with sweets and fish intake, respectively. Additionally, the father’s socio-economic status (SES) and mother’s age were associated with glucose control. Blood pressure was associated with travelling to school in vehicles, extra-virgin olive oil intake and milk/dairy consumption at breakfast. The promotion of the MedDiet, mainly having a healthy breakfast, is a good strategy to include in the management of T1D to improve glucose and metabolic control. This research is valuable for parents to obtain the best results for their children with T1D.

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Section: Dietary Factors Associated With the Risk Of Obesitysupporting

confidence: 86%

Adherence to the Mediterranean Diet Is Associated with Better Metabolic Features in Youths with Type 1 Diabetes

et al. 2022

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“…Excessive weight in type 1 diabetes results from various complex factors. Insulin replacement therapy is believed to contribute most to weight gain in people with type 1 diabetes ( 71 ), but it can also be affected by their behaviour, lifestyle choices, psychosocial factors and fear of hypoglycaemia ( 72 ). Independent factors such as age, sex and duration of disease also play a role in development of overweight/obesity ( 73 ).…”

Section: Obvious and Less Obvious Causes Of Obesity In Type 1 Diabetesmentioning

confidence: 99%

“…Their blood glucose level falls below the renal threshold and consequently, glucosuria is almost completely eliminated. Their consumed calories are conserved, leading to reduced energy expenditure and weight gain ( 71 ).…”

Section: Obvious and Less Obvious Causes Of Obesity In Type 1 Diabetesmentioning

confidence: 99%

Multi-Faceted Influence of Obesity on Type 1 Diabetes in Children – From Disease Pathogenesis to Complications

et al. 2022

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The prevalence of overweight and obesity among youth patients with diabetes type 1 is increasing. It is estimated, that even up to 35% of young patients with this type of diabetes, considered so far to be characteristic for slim figure, are overweight or even obese. General increase of obesity in children’s population complicates differential diagnosis of the type of diabetes in youths. Coexistence of obesity has clinical implications for all stages of diabetes course. It is confirmed that obesity is the risk factor for autoimmune diabetes, and is connected with the earlier onset of diabetes in predisposed patients. Many diabetic patients with obesity present additional risk factors for macroangiopathy, and are recognised to present metabolic syndrome, insulin resistance, and typical for diabetes type 2 - polycystic ovary syndrome, or non-alcoholic fatty liver disease. The prevalence of obesity rises dramatically in adolescence of diabetic child, more often in girls. It has negative impact on metabolic control, glycaemic variability and insulin demand. The risk for microangiopathic complications increases as well. The treatment is difficult and includes not only insulinotherapy and non-pharmacological trials. Recently treatment of insulin resistance with biguanids, and treatment with typical for type 2 new diabetes drugs like GLP-1 analogues, SGLT-2 receptor inhibitors, or even cases of bariatric surgery also has been reported.

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“…B. die Bewertung komplexer Mahlzeiten und entsprechende Insulingaben, Insulindosierung im Zusammenhang mit körperlicher Aktivität, Sport und auch Leistungssport [ 31 ], systematische Interpretation von CGM-Daten und Vermeidung von Überreaktionen [ 28 ], Management von kardiovaskulären Risiken, d. h. Tabak, Übergewicht, Hypertonie, Hyperlipidämie [ 32 ], sinnvolle Screenings auf Folgekomplikationen des Diabetes, realistische Einordnung des Risikos für Folgekomplikationen und Reduktion unrealistischer Ängste, Prävention von und Verhalten bei DKA, Diabetes in Beruf und Freizeit, Partnerschaft, Sexualität und Familienplanung, Alkohol und andere Drogen, riskantes Verhalten, Strategien und Hilfen bei Motivationsproblemen und Diabetes-Burn-out [ 33 ]. …”

Section: Therapieprinzipien Bei Jungen Erwachsenenunclassified

“…Management von kardiovaskulären Risiken, d. h. Tabak, Übergewicht, Hypertonie, Hyperlipidämie [ 32 ],…”

Section: Therapieprinzipien Bei Jungen Erwachsenenunclassified

Aus Sicht der Diabetespraxis: erwachsen werden mit Typ-1-Diabetes

Schlüter¹,

Lange

2022

Diabetologe

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Junge Erwachsene mit Typ-1-Diabetes tragen die Verantwortung für ihre Diabetestherapie weitgehend selbst, gleichzeitig genießen sie neu gewonnene Freiheiten und sind eher risikobereit. Die eigene Wohnung, Partnerschaft, Studium, Beruf und weitere Entwicklungsaufgaben stellen hohe Anforderungen. Diese sind oft schwer mit einer qualifizierten Diabetestherapie vereinbar. Nach der langjährigen persönlichen Bindung an das Team einer Kinderklinik ist der Wechsel in eine internistische Diabetesschwerpunktpraxis nicht immer reibungslos. Individuelle psychische Belastungen und ein unzureichendes Diabetesmanagement verstärken sich dabei gegenseitig. Diabetes verkörpert in diesem Lebensabschnitt genau das Gegenteil von all dem, was altersgemäß ist. Er erfordert einen strukturierten Tagesablauf, disziplinierte Ernährung, regelmäßige Arztbesuche und vorausschauendes Denken und Handeln. Die Analyse der CGM-Daten (CGM: kontinuierliche Glukosemessung [„continuous glucose monitoring“]) in der Diabetespraxis erlaubt detaillierte Einblicke in den persönlichen Alltag, die mit Scham- und Schuldgefühlen verbunden sein können. Ziel der Langzeitbehandlung ist es, alle diese Aspekte – aktuelle Lebensqualität, persönliche Ziele, Vermeidung akuter Diabeteskomplikationen und Prävention langfristiger kardiovaskulärer Folgekomplikationen – zu beachten und daraus partizipativ ein individuelles Behandlungskonzept zu entwickeln. Die wichtigste Aufgabe der Diabetespraxis ist dabei, junge Menschen auf ihrem individuellen Weg zu unterstützen, ihre Stärken anzuerkennen und sie durch Erfolge zu motivieren.

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Obesity in people living with type 1 diabetes

Cited by 76 publications

References 89 publications

Adherence to the Mediterranean Diet Is Associated with Better Metabolic Features in Youths with Type 1 Diabetes

Adherence to the Mediterranean Diet Is Associated with Better Metabolic Features in Youths with Type 1 Diabetes

Multi-Faceted Influence of Obesity on Type 1 Diabetes in Children – From Disease Pathogenesis to Complications

Aus Sicht der Diabetespraxis: erwachsen werden mit Typ-1-Diabetes

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