Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges

Obesity affects large numbers of patients with type 1 diabetes (T1D) across their lifetime, with rates ranging between 2.8% and 37.1%. Patients with T1D and obesity are characterized by the presence of insulin resistance, of high insulin requirements, have a greater cardiometabolic risk and an enhan...

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Autores: Vilarrasa, Nuria, San Jose, Patricia, Rubio, Miguel Ángel, Lecube, Albert
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/178976
Acceso en línea:https://hdl.handle.net/2445/178976
Access Level:acceso abierto
Palabra clave:Obesitat
Diabetis
Cirurgia de l'obesitat
Obesity
Diabetes
Obesity surgery
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spelling Obesity in Patients with Type 1 Diabetes: Links, Risks and Management ChallengesVilarrasa, NuriaSan Jose, PatriciaRubio, Miguel ÁngelLecube, AlbertObesitatDiabetisCirurgia de l'obesitatObesityDiabetesObesity surgeryObesity affects large numbers of patients with type 1 diabetes (T1D) across their lifetime, with rates ranging between 2.8% and 37.1%. Patients with T1D and obesity are characterized by the presence of insulin resistance, of high insulin requirements, have a greater cardiometabolic risk and an enhanced risk of developing chronic complications when compared to normal-weight persons with T1D. Dual treatment of obesity and T1D is challenging and no specific guidelines for improving outcomes of both glycemic control and weight management have been established for this population. Nevertheless, although evidence is scarce, a comprehensive approach based on a balanced hypocaloric diet, physical activity and cognitive behavioral therapy by a multidisciplinary team, expert in both obesity and diabetes, remains as the best clinical practice. However, weight loss responses with lifestyle changes alone are limited, so in the "roadmap" of the treatment of obesity in T1D, it will be helpful to include anti-obesity pharmacotherapy despite at present there is a lack of evidence since T1D patients have been excluded from anti-obesity drug clinical trials. In case of severe obesity, bariatric surgery has proven to be of benefit in obtaining a substantial and long-term weight loss and reduction in cardiovascular risk. The near future looks promising with the development of new and more effective anti-obesity treatments and strategies to improve insulin resistance and oxidative stress. Advances in precision medicine may help individualize and optimize the medical management and care of these patients. This review, by gathering current evidence, highlights the need of solid knowledge in all facets of the treatment of patients with obesity and T1D that can only be obtained through high quality well-designed studies.Informa UK Limited2021info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/2445/178976Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.2147/DMSO.S223618Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2021, vol. 14, p. 2807-2827https://doi.org/10.2147/DMSO.S223618cc by-nc (c) Vilarrasa, Nuria et al., 2021http://creativecommons.org/licenses/by-nc/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1789762026-05-27T06:46:51Z
dc.title.none.fl_str_mv Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges
title Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges
spellingShingle Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges
Vilarrasa, Nuria
Obesitat
Diabetis
Cirurgia de l'obesitat
Obesity
Diabetes
Obesity surgery
title_short Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges
title_full Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges
title_fullStr Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges
title_full_unstemmed Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges
title_sort Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges
dc.creator.none.fl_str_mv Vilarrasa, Nuria
San Jose, Patricia
Rubio, Miguel Ángel
Lecube, Albert
author Vilarrasa, Nuria
author_facet Vilarrasa, Nuria
San Jose, Patricia
Rubio, Miguel Ángel
Lecube, Albert
author_role author
author2 San Jose, Patricia
Rubio, Miguel Ángel
Lecube, Albert
author2_role author
author
author
dc.subject.none.fl_str_mv Obesitat
Diabetis
Cirurgia de l'obesitat
Obesity
Diabetes
Obesity surgery
topic Obesitat
Diabetis
Cirurgia de l'obesitat
Obesity
Diabetes
Obesity surgery
description Obesity affects large numbers of patients with type 1 diabetes (T1D) across their lifetime, with rates ranging between 2.8% and 37.1%. Patients with T1D and obesity are characterized by the presence of insulin resistance, of high insulin requirements, have a greater cardiometabolic risk and an enhanced risk of developing chronic complications when compared to normal-weight persons with T1D. Dual treatment of obesity and T1D is challenging and no specific guidelines for improving outcomes of both glycemic control and weight management have been established for this population. Nevertheless, although evidence is scarce, a comprehensive approach based on a balanced hypocaloric diet, physical activity and cognitive behavioral therapy by a multidisciplinary team, expert in both obesity and diabetes, remains as the best clinical practice. However, weight loss responses with lifestyle changes alone are limited, so in the "roadmap" of the treatment of obesity in T1D, it will be helpful to include anti-obesity pharmacotherapy despite at present there is a lack of evidence since T1D patients have been excluded from anti-obesity drug clinical trials. In case of severe obesity, bariatric surgery has proven to be of benefit in obtaining a substantial and long-term weight loss and reduction in cardiovascular risk. The near future looks promising with the development of new and more effective anti-obesity treatments and strategies to improve insulin resistance and oxidative stress. Advances in precision medicine may help individualize and optimize the medical management and care of these patients. This review, by gathering current evidence, highlights the need of solid knowledge in all facets of the treatment of patients with obesity and T1D that can only be obtained through high quality well-designed studies.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/178976
url https://hdl.handle.net/2445/178976
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.2147/DMSO.S223618
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2021, vol. 14, p. 2807-2827
https://doi.org/10.2147/DMSO.S223618
dc.rights.none.fl_str_mv cc by-nc (c) Vilarrasa, Nuria et al., 2021
http://creativecommons.org/licenses/by-nc/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc (c) Vilarrasa, Nuria et al., 2021
http://creativecommons.org/licenses/by-nc/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Informa UK Limited
publisher.none.fl_str_mv Informa UK Limited
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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