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Shattering myths: Study reveals new insights on Type 1 diabetes and obesity link

Researchers have reviewed recent advancements in information about Type 1 diabetes and weight disorders. Their findings shatter the myths that Type 1 diabetes is a the chronic condition only affects slim children and adolescents.

Background of obesity and diabetes

More than 1 billion people worldwide are obese. Changing trends in diet and physical activity are driving these increases in obesity, which have almost tripled since 1975 and Western countries are the worst affected.

Compared to the far more common Type 2 diabetes, Type 1 diabetes is often seen as rare – it affects between 3-10% of people with diabetes. It is an autoimmune disorder and is characterised by the reduced or complete inability of the pancreas to produce insulin which results in a toxic buildup of sugar in the bloodstream. Historically, the onset of Type 1 was seen in adolescents, but recent research has discovered that it can develop in people of any age group.

Study findings

  • Unlike previously thought, overweight and obesity are significantly positively associated with Type 1 diabetes.
  • Research has shown that in adolescents between the ages of 16 and 19, every incremental standard deviation (SD) from average body mass index (BMI) was associated with a 25% increased risk of developing Type 1 diabetes.
  • Unexpectedly the study found that children with severe obesity, therefore, high Type 1 risk, could drastically reduce this risk by up to 22% for every 10% of weight loss. This suggests that weight management interventions before the onset of Type 1 diabetes has the potential to prevent the development of the condition which would improve the futures of thousands of children and adults at risk of diabetes.

This review highlights that research shows significant differences in the association between Type 1 diabetes and obesity in different parts of the world.

In addition, the last few decades have seen increases in poor health behaviours, particularly the consumption of energy-dense foods (eg the Western diet) and the shift to highly sedentary lifestyles, especially after Covid and working from home. It is now known obesity arises from a combination of genetic, political, socioeconomic and cultural factors.

In Type 1 diabetes, treating obesity is complicated by intensive insulin therapy, which causes weight gain and is a challenge for achieving weight management goals. Type 1 diabetes characterised by the induction of beta-call inflammation but this is made more difficult by obesity due to the other conditions this causes, including lipotoxicity, mitochondrial dysfunction, glucotoxicity, adipose tissue damage, endocrine alterations and the recently described imbalances in gut microbial communities.

However, current research fails to incorporate these effects in its predictions and intervention recommendations which often result in suboptimal outcomes. Future clinical research should account for the holistic effects of Type 1 diabetes and obesity rather than focus on one at the cost of the other.

Conclusions

For many years Type 1 diabetes has received less research interest than Type 2 diabetes which has resulted in myths and misinformation about its risk factors and treatments. Recent research has begun to shatter these myths showing that Type 1 is more common than previously thought and is expected to rise in coming years. In addition, Type 1 is not restricted lean young people but can occur at any age.

The review recommends that future research, policy and interventions must be patient-specific and tailored to address Type 1 diabetes, obesity and their comorbidities simultaneously. (International Journal of Obesity, December 2023)

InDependent Diabetes Trust
IDDT