Over recent years, excess weight gain has become more common among people with type 1 diabetes (T1D). If someone with T1D becomes overweight or obese, this can add to their long-term health risks. Research in people without diabetes has shown that overweight and obesity are important risk factors for type 2 diabetes, cardiovascular disease, some types of cancer, and early death. Obesity is also linked to anxiety, depression, and self-harm. Although there is not a lot of long-term data in people with T1D, existing data shows that the effects of overweight and obesity are important for this population. Some people can end up with “double diabetes.” This is when a person has both type 1 and type 2 diabetes.
More people with T1D are gaining excess weight
Mexico has one of the highest rates of overweight and obesity in the world. In Mexico, among people with T1D, 34% are overweight and 8% are obese. These rates of overweight and obesity in people with T1D were lower than for the general Mexican population. The concern is that the rates in T1D are likely to rise. In the U.S., estimates suggest that 29% of adults with T1D are overweight and 20% are obese. In children with T1D, excess weight gain is also common.
More research is urgently needed
One of the challenges for people living with T1D is to achieve control of both blood sugar and weight. This is difficult with insulin, as gaining weight is associated with insulin resistance. This requires more insulin, leading to a vicious cycle. Preventing or treating excess weight gain in T1D is very challenging due to concerns about low blood sugar levels (hypoglycemia) associated with restricting carbohydrates and exercise if appropriate changes to an insulin regimen are not made. Other options include drugs, although side effects and cost are concerns. Some drugs for obesity require injection, adding to the personal burden for people with T1D.
The existing evidence already indicates that undesired weight gain is a reason for concern in treating people living with T1D, but there is a lack of good-quality and long-term data.
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