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dc.contributor.authorVilarrasa, Núria
dc.contributor.authorSan Jose, Patricia
dc.contributor.authorRubio, Miguel Ángel
dc.contributor.authorLecube Torelló, Albert
dc.description.abstractObesity 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.ca_ES
dc.description.sponsorshipNV is the recipient of grants “Ajuts per a projectes de recerca clínica de L’Hospital Universitari de Bellvitge (2011-PR143/11)” and of the project “PI11/01960; PI14/ 01997 and PI17/01556” funded by the Instituto de Salud Carlos III and co-funded by the European Union (ERDF, “A way to build Europe”). AL is the recipient of grant PI18/00964. The Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders (CIBERDEM) (CB07708/0012) is an initiative of the Instituto de Salud Carlos IIIca_ES
dc.publisherDove Medical Pressca_ES
dc.relation.isformatofReproducció del document publicat a
dc.relation.ispartofDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2021, vol.14, p. 2807-2827ca_ES
dc.rightscc-by-nc (c) Vilarrasa et al., 2021ca_ES
dc.subjectType 1 diabetesca_ES
dc.subjectDual diabetesca_ES
dc.subjectInsulin resistanceca_ES
dc.subjectMetabolic syndromeca_ES
dc.titleObesity in Patients with Type 1 Diabetes: Links, Risks and Management Challengesca_ES

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cc-by-nc (c) Vilarrasa et al., 2021
Except where otherwise noted, this item's license is described as cc-by-nc (c) Vilarrasa et al., 2021