[Influence of body weight on the natural history of and the therapeutic approaches to type 1 diabetes]

Rev Med Liege. 2012 Sep;67(9):461-7.
[Article in French]


Obesity, whose prevalence is increasing in industrialized countries, is recognized as a major risk factor for the development of type 2 diabetes. In contrast, the role of excess adiposity in the natural history of type 1 diabetes (T1DM) and its impact on therapeutic approaches are by far less known and most probably largely underestimated. The following items will be most particularly considered: 1) the accelerator role of obesity in the development of T1DM in young predisposed individuals; 2) the difficult diagnosis in presence of hybrid or double diabetes combining insulin secretory defect and insulin resistance; 3) the problem of managing both body weight and glucose control, especially in young females and adolescents; 4) the possible deleterious effects of intensive insulin therapy on body weight and some markers of the metabolic syndrome; 5) the worse cardiovascular prognosis of T1DM patients when obesity is present; 6) the possible role of other medications as adjunct therapy to insulin in insulin resistant obese T1DM patients; and finally 7) the expected benefit of bariatric surgery in some well selected T1DM patients with severe obesity.

MeSH terms

  • Adolescent
  • Bariatric Surgery
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Metabolic Syndrome / drug therapy
  • Metabolic Syndrome / physiopathology
  • Obesity / physiopathology*
  • Obesity / surgery
  • Risk Factors


  • Hypoglycemic Agents
  • Insulin