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Weight Management in Youth with Type 1 Diabetes and Obesity: Challenges and Possible Solutions

  • Childhood Obesity (A Kelly and C Fox, Section Editor)
  • Published:
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Abstract

Purpose of Review

This review highlights challenges associated with weight management in children and adolescents with type 1 diabetes (T1D). Our purpose is to propose potential solutions to improve weight outcomes in youth with T1D.

Recent Findings

A common barrier to weight management in T1D is reluctance to engage in exercise for fear of hypoglycemia. Healthcare practitioners generally provide limited guidance for insulin dosing and carbohydrate modifications to maintain stable glycemia during exercise. Adherence to dietary guidelines is associated with improved glycemia; however, youth struggle to meet recommendations. When psychosocial factors are addressed in combination with glucose trends, this often leads to successful T1D management. Newer medications also hold promise to potentially aid in glycemia and weight management, but further research is necessary.

Summary

Properly addressing physical activity, nutrition, pharmacotherapy, and psychosocial factors while emphasizing weight management may reduce the likelihood of obesity development and its perpetuation in this population.

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Authors and Affiliations

  1. Division of Endocrinology, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA

    Dessi P. Zaharieva, Ananta Addala & David M. Maahs

  2. Barbara Davis Center for Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA

    Kimber M. Simmons

  3. Stanford Diabetes Research Center, Stanford, CA, USA

    David M. Maahs

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DPZ has received speaking honoraria from Medtronic Diabetes, Ascensia Diabetes, and Insulet. AA is supported by the Maternal Child Health Research Institute at Stanford University and is an Ernest and Amelia Gallo Endowed Postdoctoral Fellow. KMS is a consultant for Dexcom and has had research support from NIH, JDRF, and the Helmsley Charitable Trust. DMM has had research support from the NIH, JDRF, NSF, and the Helmsley Charitable Trust, and his institution has had research support from Medtronic Diabetes, Dexcom, Insulet, Bigfoot Biomedical, Tandem, and Roche. DMM has also consulted for Abbott, the Helmsley Charitable Trust, Sanofi, Novo Nordisk, Eli Lilly, Medtronic, and Insulet.

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Zaharieva, D.P., Addala, A., Simmons, K.M. et al. Weight Management in Youth with Type 1 Diabetes and Obesity: Challenges and Possible Solutions. Curr Obes Rep 9, 412–423 (2020). https://doi.org/10.1007/s13679-020-00411-z

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