Hormonal
Intensive insulin therapy in Type 1 Diabetes causes significant weight gain, which subsequently increases the risk of cardiovascular disease and metabolic complications.
If you have Type 1 Diabetes, intensive insulin therapy is necessary for survival and complication prevention, but it will likely cause weight gain. Do not restrict insulin to control weight, as this leads to dangerous hyperglycemia and increased mortality. Instead, work with your care team to manage weight through lifestyle adjustments and potentially adjunctive therapies that do not compromise glycemic control.
A key contributor to obesity in T1D is the weight gain that occurs with intensive insulin therapy... The DCCT demonstrated the importance of intensive insulin therapy for achieving optimal glycemic control... even with the demonstration of a clear association between intensive insulin therapy and weight gain, insulin is the foundation of T1D medical management.
Why this rating
Supported by long-term observational data from DCCT/EDIC and multiple registry studies, though RCTs on weight specifically are limited.
Source
Obesity in Type 1 Diabetes: Pathophysiology, Clinical Impact, and Mechanisms
Karen D. Corbin et al. · Endocrine Reviews · 2018
DOI 10.1210/er.2017-00191
More from this paper
- Insulin manipulation (restriction) to control weight in Type 1 Diabetes leads to chronic hyperglycemia, increased morbidity, and a threefold increase in relative risk of death.Good
- Adjunctive therapies such as pramlintide, metformin, and GLP-1 receptor agonists can improve glycemic control and promote weight loss or weight neutrality in Type 1 Diabetes when added to insulin therapy.Moderate
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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