The emergence of obesity in type 1 diabetes

Abstract

Obesity, a chronic low-grade inflammatory disease represented by multifactorial metabolic dysfunctions, is a significant global health threat for adults and children. The once-held belief that type 1 diabetes is a disease of people who are lean no longer holds. The mounting epidemiological data now establishes the connection between type 1 diabetes and the subsequent development of obesity, or vice versa. Beyond the consequences of the influx of an obesogenic environment, type 1 diabetes-specific biopsychosocial burden further exacerbates obesity. In the course of obesity management discussions, recurring challenges surfaced. The interplay between weight gain and escalating insulin dependence creates a vicious cycle from which patients struggle to break free. In the absence of weight management guidelines and regulatory approval for this population, healthcare professionals must navigate the delicate balance between benefits and risks. The gravity of this circumstance highlights the importance of bringing these topics to the forefront. In this Review, we discuss the changing trends and the biopsychosocial aspects of the intersection between type 1 diabetes and obesity. We highlight the evidence supporting the therapeutic means (i.e., exercise therapy, nutritional therapy, adjunct pharmacotherapy, and bariatric surgery) and directions for establishing a more robust and safer evidence-based approach.

A Non-Toxic Binuclear Vanadium(IV) Complex as Insulin Adjuvant Improves the Glycemic Control in Streptozotocin-Induced Diabetic Rats

“…Oxidative stress in diabetes in humans plays roles in both the origin of the disease and in increasing secondary complications [ 88 ], resulting in the production of free radicals, especially in the pancreas, which is a major cause of insulin resistance in both type 1 [ 96 ] and type 2 diabetes [ 97 ]. Associated with the fact that the type 1 diabetes treatment regimen is associated with weight gain [ 98 ], and a higher BMI is related to worse metabolic control [ 99 , 100 ], there is a need for adjuvant therapy with insulin, which improves glycemic control and reduces insulin requirements [ 101 ].…”

The potential impact fraction of population weight reduction scenarios on non-communicable diseases in Belgium: application of the g-computation approach

“…While our findings demonstrate a significant association between BMI and diabetes, it must be recognized that the impact of BMI may vary between type 1 and type 2 diabetes. While the link between obesity and type 2 diabetes is well-established, emerging evidence suggests a link between obesity and type 1 diabetes as well [ 70 ]. Future research could explore this aspect further to elucidate whether BMI affects both types of diabetes similarly.…”

Overweight and Obesity in Adults with Type 1 Diabetes: A Growing Challenge

“…It is known that developed countries have more available pharmacotherapy as well as technological innovations, which today have a significant role in treatment. Unequal access to treatment resources will result in significant differences in glycemic control and consequently the appearance of obesity-related complications, especially in groups of lower socioeconomic status [82]. Current clinical guidelines lack evidence on the most appropriate weight management strategies in people living with T1D and obesity.…”