851
Views
20
CrossRef citations to date
0
Altmetric
Review

Obesity in Patients with Type 1 Diabetes: Links, Risks and Management Challenges

ORCID Icon, , &
Pages 2807-2827 | Published online: 21 Jun 2021

References

  • Afshin A , Forouzanfar MH , Reitsma MB , et al.; GBD 2015 Obesity Collaborators. Effects of overweight and obesity in 195 countries over 25 years. N Engl J Med . 2017;377(1):13–27. doi:10.1056/NEJMoa1614362 28604169
  • Corbin KD , Driscoll KA , Pratley RE , Smith SR , Maahs DM , Mayer-Davis EJ . Advancing care for Type 1 diabetes and obesity network (ACT1ON). Obesity in type 1 diabetes: pathophysiology, clinical impact, and mechanisms. Endocr Rev . 2018;39:629–663. doi:10.1210/er.2017-00191 30060120
  • American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021. Diabetes Care . 2021;44(Suppl1):S15–S33. doi:10.2337/dc21-S002 33298413
  • Polsky S , Ellis SL . Obesity, insulin resistance, and type 1 diabetes mellitus. Curr Opin Endocrinol Diabetes Obes . 2015;22:277–282. doi:10.1097/MED.0000000000000170 26087341
  • Pinhas-Hamiel O , Levek-Motola N , Kaidar K , et al. Prevalence of overweight, obesity and metabolic syndrome components in children, adolescents and young adults with type 1 diabetes mellitus. Diabetes Metab Res Rev . 2015;31:76–84. doi:10.1002/dmrr.2565 24827815
  • Minges KE , Whittemore R , Weinzimer SA , Irwin ML , Redeker NS , Grey M . Correlates of overweight and obesity in 5529 adolescents with type 1 diabetes: the T1D Exchange Clinic Registry. Diabetes Res Clin Pract . 2017;126:68–78. doi:10.1016/j.diabres.2017.01.012 28214669
  • Fröhlich-Reiterer EE , Rosenbauer J , Bechtold-Dalla Pozza S , Hofer SE , Schober E , Holl RW . Predictors of increasing BMI during the course of diabetes in children and adolescents with type 1 diabetes: data from the German/Austrian DPV multicentre survey. Arch Dis Child . 2014;99:738–743. doi:10.1136/archdischild-2013-304237 24812301
  • DuBose SN , Hermann JM , Tamborlane WV , et al. Type 1 Diabetes Exchange Clinic Network and Diabetes Prospective Follow-up Registry. Obesity in youth with type 1 diabetes in Germany, Austria, and the United States. J Pediatr . 2015;167:627–632. doi:10.1016/j.jpeds.2015.05.046 26164381
  • Liu LL , Lawrence JM , Davis C , et al.; SEARCH for Diabetes in Youth Study Group. Prevalence of overweight and obesity in youth with diabetes in USA: the SEARCH for Diabetes in Youth study. Pediatr Diabetes . 2010;11:4–11. doi:10.1111/j.1399-5448.2009.00519.x 19473302
  • Vestberg D , Rosengren A , Olsson M , Gudbjörnsdottir S , Svensson AM , Lind M . Relationship between overweight and obesity with hospitalization for heart failure in 20,985 patients with type 1 diabetes: a population-based study from the Swedish National Diabetes Registry. Diabetes Care . 2013;36:2857–2861. doi:10.2337/dc12-2007 23757423
  • Holt SK , Lopushnyan N , Hotaling J , et al. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Prevalence of low testosterone and predisposing risk factors in men with type 1 diabetes mellitus: findings from the DCCT/EDIC. J Clin Endocrinol Metab . 2014;99:E1655–1660. doi:10.1210/jc.2014-1317 25013994
  • Fourlanos S , Elkassaby S , Varney MD , Colman PG , Harrison LC . Higher body mass index in adults at diagnosis of the slowly progressive form of type 1 diabetes mellitus is associated with lower risk HLA genes. Diabetes Res Clin Pract . 2014;104:e69–71. doi:10.1016/j.diabres.2014.03.009 24698405
  • Islam ST , Abraham A , Donaghue KC , et al. Plateau of adiposity in Australian children diagnosed with Type 1 diabetes: a 20-year study. Diabet Med . 2014;31:686–690. doi:10.1111/dme.12402 24495260
  • Baskaran C , Volkening LK , Diaz M , Laffel LM . A decade of temporal trends in overweight/obesity in youth with type 1 diabetes after the Diabetes Control and Complications Trial. Pediatr Diabetes . 2015;16:263–270. doi:10.1111/pedi.12166 25039317
  • Conway B , Miller RG , Costacou T , et al. Temporal patterns in overweight and obesity in type 1 diabetes. Diabet Med . 2010;27:398–404. doi:10.1111/j.1464-5491.2010.02956.x 20536510
  • Nathan DM , Zinman B , Cleary PA , et al.; Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group. Modern-day clinical course of type 1 diabetes mellitus after 30 years’ duration: the diabetes control and complications trial/ epidemiology of diabetes interventions and complications and Pittsburgh epidemiology of diabetes complications experience (1983–2005). Arch Intern Med . 2009;169:1307–1316. doi:10.1001/archinternmed.2009.193 19636033
  • Verbeeten KC , Elks CE , Daneman D , Ong KK . Association between childhood obesity and subsequent Type 1 diabetes: a systematic review and meta-analysis. Diabet Med . 2011;28:10–18. doi:10.1111/j.1464-5491.2010.03160.x 21166841
  • Harder T , Roepke K , Diller N , Stechling Y , Dudenhausen JW , Plagemann A . Birth weight, early weight gain, and subsequent risk of Type 1 diabetes: systematic review and meta-analysis. Am J Epidemiol . 2009;169:1428–1436. doi:10.1093/aje/kwp065 19363100
  • Betts P , Mulligan J , Ward P , et al. Increasing body weight predicts the earlier onset of insulin-dependent diabetes in childhood: testing the ‘accelerator hypothesis’ (2). Diabet Med . 2005;22:144–151. doi:10.1111/j.1464-5491.2004.01368.x 15660730
  • Svensson J , Carstensen B , Mortensen HB , Borch-Johnsen K . Growth in the first year of life and the risk of type 1 diabetes in a Danish population. Paediatr Perinat Epidemiol . 2007;21:44–48. doi:10.1111/j.1365-3016.2007.00775.x 17239178
  • EURODIAB Substudy 2 Study Group. Rapid early growth is associated with increased risk of childhood Type 1 diabetes in various European populations. Diabetes Care . 2002;25:1755–1760. doi:10.2337/diacare.25.10.1755 12351473
  • Hypponen E , Virtanen SM , Kenward MG , Knip M , Akerblom HK . Obesity, increased linear growth, and risk of Type 1 diabetes in children. Diabetes Care . 2000;23:1755–1760. doi:10.2337/diacare.23.12.1755 11128347
  • Viner RM , Hindmarsh PC , Taylor B , et al. Childhood body mass index (BMI), breastfeeding and risk of Type 1 diabetes: findings from a longitudinal national birth cohort. Diabet Med . 2008;25:1056–1061. doi:10.1111/j.1464-5491.2008.02525.x 19183310
  • Berhan Y , Waernbaum I , Lind T , Möllsten A , Dahlquist G ; Swedish Childhood Diabetes Study Group. Thirty years of prospective nationwide incidence of childhood type 1 diabetes: the accelerating increase by time tends to level off in Sweden. Diabetes . 2011;60:577–581. doi:10.2337/db10-0813 21270269
  • Bruining GJ . Association between infant growth before onset of juvenile type-1 diabetes and autoantibodies to IA-2. Lancet . 2000;356:655–656. doi:10.1016/s0140-6736(00)02612-x 10968443
  • Lammi N , Moltchanova E , Blomstedt PA , Tuomilehto J , Eriksson JG , Karvonen M . Childhood BMI trajectories and the risk of developing young adult onset diabetes. Diabetologia . 2009;52:408–414. doi:10.1007/s00125-008-1244-0 19130040
  • González-álvarez MA , Lázaro-Alquézar A , Simón-Fernández MB . Global trends in child obesity: are figures converging? Int J Environ Res Public Health . 2020;17(24):9252. doi:10.3390/ijerph17249252
  • Wilkin TJ . The convergence of type 1 and type 2 diabetes in childhood: the accelerator hypothesis. Pediatr Diabetes . 2012;13:334–339. doi:10.1111/j.1399-5448.2011.00831.x 22059423
  • Tang C , Naassan AE , Chamson-Reig A , et al. Susceptibility to fatty acid-induced β-cell dysfunction is enhanced in prediabetic diabetes-prone biobreeding rats: a potential link between β-cell lipotoxicity and islet inflammation. Endocrinology . 2013;154:89–101. doi:10.1210/en.2012-1720 23150493
  • Tsui H , Paltser G , Chan Y , Dorfman R , Dosch HM . ‘Sensing’ the link between type 1 and type 2 diabetes. Diabetes Metab Res Rev . 2011;27:913–918. doi:10.1002/dmrr.1279 22069284
  • Găman MA , Epîngeac ME , Diaconu CC , Găman AM . Evaluation of oxidative stress levels in obesity and diabetes by the free oxygen radical test and free oxygen radical defence assays and correlations with anthropometric and laboratory parameters. World J Diabetes . 2020;11(5):193–201. doi:10.4239/wjd.v11.i5.193 32477455
  • Yang Y , Torchinsky MB , Gobert M , et al. Focused specificity of intestinal TH17 cells towards commensal bacterial antigens. Nature . 2014;510:152–156. doi:10.1038/nature13279 24739972
  • Tai N , Wong FS , Wen L . The role of gut microbiota in the development of type 1, type 2 diabetes mellitus and obesity. Rev Endocr Metab Disord . 2015;16:55–65. doi:10.1007/s11154-015-9309-0 25619480
  • Grant SFA . The TCF7L2 locus: a genetic window into the pathogenesis of type 1 and type 2 diabetes. Diabetes Care . 2019;42:1624–1629. doi:10.2337/dci19-0001 31409726
  • Field SF , Howson JM , Smyth DJ , Walker NM , Dunger DB , Todd JA . Analysis of the type 2 diabetes gene, TCF7L2, in 13,795 type 1 diabetes cases and control subjects. Diabetologia . 2007;50:212–213. doi:10.1007/s00125-006-0506-y 17063324
  • Redondo MJ , Geyer S , Steck AK , et al.; Type 1 Diabetes TrialNet Study Group. TCF7L2 genetic variants contribute to phenotypic heterogeneity of type 1 diabetes. Diabetes Care . 2018;41:311–317. doi:10.2337/dc17-0961 29025879
  • Purnell JQ , Hokanson JE , Marcovina SM , Steffes MW , Cleary PA , Brunzell JD . Effect of excessive weight gain with intensive therapy of type 1 diabetes on lipid levels and blood pressure: results from the DCCT. Diabetes Control and Complications Trial. JAMA . 1998;280(2):140–146. Erratum in: JAMA 1998 Nov 4;280(17):1484. doi:10.1001/jama.280.2.140 9669786
  • Purnell JQ , Zinman B , Brunzell JD . The effect of excess weight gain with intensive diabetes mellitus treatment on cardiovascular disease risk factors and atherosclerosis in type 1 diabetes mellitus: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC) study. Circulation . 2013;127(2):180–187. doi:10.1161/CIRCULATIONAHA.111.077487 23212717
  • Teupe B , Bergis K . Epidemiological evidence for “double diabetes”. Lancet (London, England) . 1991;337(8737):361–362. doi:10.1016/0140-6736(91)90988-2
  • Chillarón JJ , Flores Le-roux JA , Benaiges D , Pedro-Botet J . Type 1 diabetes, metabolic syndrome and cardiovascular risk. Metabolism . 2014;63(2):181–187. doi:10.1016/j.metabol.2013.10.002 24274980
  • Rodrigues TC , Veyna AM , Haarhues MD , Kinney GL , Rewers M , Snell-Bergeon JK . Obesity and coronary artery calcium in diabetes: the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study. Diabetes Technol Ther . 2011;13:991–996. doi:10.1089/dia.2011.0046 21770813
  • Price SA , Gorelik A , Fourlanos S , Colman PG , Wentworth JM . Obesity is associated with retinopathy and macrovascular disease in type 1 diabetes. Obes Res Clin Pract . 2014;8:e178–e182. doi:10.1016/j.orcp.2013.03.007 24743014
  • Kaštelan S , Salopek Rabatić J , Tomić M , et al. Body mass index and retinopathy in type 1 diabetic patients. Int J Endocrinol . 2014;2014:387919. doi:10.1155/2014/387919 24696683
  • Dobrică EC , Găman MA , Cozma MA , Bratu OG , Pantea Stoian A , Diaconu CC . Polypharmacy in type 2 diabetes mellitus: insights from an internal medicine department. Medicina (Kaunas) . 2019;55(8):436. doi:10.3390/medicina55080436
  • American Diabetes Association. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes. 2021. Diabetes Care . 2021;44(Suppl1):S111–S124. doi:10.2337/dc21-S009 33298420
  • The DCCT Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med . 1993;329:977–986. doi:10.1056/NEJM199309303291401 8366922
  • Mattes R , Foster GD . Food environment and obesity. Obesity (Silver Spring) . 2014;22(12):2459–2461. doi:10.1002/oby.20922 25401929
  • Solmi M , Ioannidis JPA , Carvalho AF . Environmental risk factors and interventions for obesity. Eur J Clin Invest . 2019;49(5):e13080. doi:10.1111/eci.13080 30725492
  • Durrer Schutz D , Busetto L , Dicker D , et al. European practical and patient-centred guidelines for adult obesity management in primary care. Obes Facts . 2019;12(1):40–66. doi:10.1159/000496183 30673677
  • Woods SC , Lutz TA , Geary N , Langhans W . Pancreatic signals controlling food intake; insulin, glucagon and amylin. Philos Trans R Soc Lond B Biol Sci . 2006;361(1471):1219–1235. doi:10.1098/rstb.2006.1858 16815800
  • Dinneen S , Alzaid A , Turk D , Rizza R . Failure of glucagon suppression contributes to postprandial hyperglycaemia in IDDM. Diabetologia . 1995;38:337–343. doi:10.1007/BF00400639 7758881
  • Zaharieva DP , Addala A , Simmons KM , Maahs DM . Weight management in youth with type 1 diabetes and obesity: challenges and possible solutions. Curr Obes Rep . 2020;9(4):412–423. doi:10.1007/s13679-020-00411-z 33108635
  • Mottalib A , Tomah S , Hafida S , et al. Intensive multidisciplinary weight management in patients with type 1 diabetes and obesity: a one-year retrospective matched cohort study. Diabetes Obes Metab . 2019;21(1):37–42. doi:10.1111/dom.13478 30047220
  • Garvey WT , Mechanick JI , Brett EM , et al. American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines for Medical Care of Patients with Obesity. Endocr Pract . 2016;22(suppl 3):1–230. doi:10.4158/EP161365.GL
  • Kahkoska AR , Watts ME , Driscoll KA , et al. Understanding antagonism and synergism: a qualitative assessment of weight management in youth with type 1 diabetes mellitus. Obes Med . 2018;9:21–31. doi:10.1016/j.obmed.2017.12.001 29984330
  • Dornhorst A , Lüddeke HJ , Sreenan S , et al.; PREDICTIVE Study Group. Insulin detemir improves glycaemic control without weight gain in insulin-naïve patients with type 2 diabetes: subgroup analysis from the PREDICTIVE study. Int J Clin Pract . 2008;62(4):659–665. doi:10.1111/j.1742-1241.2008.01715.x 18324957
  • Holmes RS , Crabtree E , McDonagh MS . Comparative effectiveness and harms of long-acting insulins for type 1 and type 2 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab . 2019;21(4):984–992. doi:10.1111/dom.13614 30552792
  • Madenidou AV , Paschos P , Karagiannis T , et al. Comparative benefits and harms of basal insulin analogues for type 2 diabetes: a systematic review and network meta-analysis. Ann Intern Med . 2018;169(3):165–174. doi:10.7326/M18-0443 29987326
  • Blair JC , McKay A , Ridyard C . Continuous subcutaneous insulin infusion versus multiple daily injection regimens in children and young people at diagnosis of type 1 diabetes: pragmatic randomised controlled trial and economic evaluation. BMJ . 2019;365:l1226. doi:10.1136/bmj.l1226 30944112
  • Alderisio A , Bozzetto L , Franco L , Riccardi G , Rivellese AA , Annuzzi G . Long-term body weight trajectories and metabolic control in type 1 diabetes patients on insulin pump or multiple daily injections: a 10-year retrospective controlled study. Nutr Metab Cardiovasc Dis . 2019;29(10):1110–1117. doi:10.1016/j.numecd.2019.06.008 31371264
  • American Diabetes Association. Facilitating behavior change and well-being to improve health outcomes: standards of medical care in diabetes-2021. Diabetes Care . 2021;44(Suppl1):S53–S72. doi:10.2337/dc21-S005 33298416
  • Ballesteros Pomar MD , Vilarrasa García N , Rubio Herrera MÁ , et al. The SEEN comprehensive clinical survey of adult obesity: executive summary. Endocrinol Diabetes Nutr . 2021;68(2):130–136. doi:10.1016/j.endinu.2020.05.003
  • American Diabetes Association. Children and adolescents: standards of medical care in diabetes-2021. Diabetes Care . 2021;44(Suppl1):S180–S199. doi:10.2337/dc21-S013 33298424
  • Estruch R , Ros E , Salas-Salvadó J , et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med . 2013;368(14):1279–1290. doi:10.1056/NEJMoa1200303 23432189
  • Sofi F , Abbate R , Gensini GF , Casini A . Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr . 2010;92(5):1189–1196. doi:10.3945/ajcn.2010.29673 20810976
  • Fortin A , Rabasa-Lhoret R , Lemieux S , Labonté ME , Gingras V . Comparison of a Mediterranean to a low-fat diet intervention in adults with type 1 diabetes and metabolic syndrome: a 6-month randomized trial. Nutr Metab Cardiovasc Dis . 2018;28(12):1275–1284. doi:10.1016/j.numecd.2018.08.005 30459054
  • Scott SN , Anderson L , Morton JP , Wagenmakers AJM , Riddell MC . Carbohydrate restriction in type 1 diabetes: a realistic therapy for improved glycaemic control and athletic performance? Nutrients . 2019;11(5):1022. doi:10.3390/nu11051022
  • Ranjan A , Schmidt S , Damm-Frydenberg C , et al. Low-carbohydrate diet impairs the effect of glucagon in the treatment of insulin-induced mild hypoglycemia: a Randomized Crossover Study. Diabetes Care . 2017;40(1):132–135. doi:10.2337/dc16-1472 27797928
  • Eiswirth M , Clark E , Diamond M . Low carbohydrate diet and improved glycaemic control in a patient with type one diabetes. Endocrinol Diabetes Metab Case Rep . 2018;2018:18. doi:10.1530/EDM-18-0002
  • Krebs JD , Strong AP , Cresswell P , Reynolds AN , Hanna A , Haeusler S . A randomised trial of the feasibility of a low carbohydrate diet vs standard carbohydrate counting in adults with type 1 diabetes taking body weight into account. Asia Pac J Clin Nutr . 2016;25:78–84. doi:10.6133/apjcn.2016.25.1.11 26965765
  • Nielsen JV , Jönsson E , Ivarsson A . A low carbohydrate diet in type 1 diabetes: clinical experience—A brief report. Upsala J Med Sci . 2005;110:267–273. doi:10.3109/2000-1967-074 16454166
  • Schmidt S , Christensen MB , Serifovski N , et al. Low versus high carbohydrate diet in type 1 diabetes: a 12-week randomized open-label crossover study. Diabetes Obes Metab . 2019;21(7):1680–1688. doi:10.1111/dom.13725 30924570
  • Turton JL , Raab R , Rooney KB . Low-carbohydrate diets for type 1 diabetes mellitus: a systematic review. PLoS One . 2018;13(3):e0194987. doi:10.1371/journal.pone.0194987 29596460
  • Rynders CA , Thomas EA , Zaman A , Pan Z , Catenacci VA , Melanson EL . Effectiveness of intermittent fasting and time-restricted feeding compared to continuous energy restriction for weight loss. Nutrients . 2019;11(10):pii: E2442. doi:10.3390/nu11102442
  • Cioffi I , Evangelista A , Ponzo V , et al. Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials. J Transl Med . 2018;16(1):371. doi:10.1186/s12967-018-1748-4 30583725
  • Absil H , Baudet L , Robert A , Lysy PA . Benefits of physical activity in children and adolescents with type 1 diabetes: a systematic review. Diabetes Res Clin Pract . 2019;156:107810. doi:10.1016/j.diabres.2019.107810 31401153
  • Sundberg F , Forsander G , Fasth A , Ekelund U . Children younger than 7 years with type 1 diabetes are less physically active than healthy controls. Acta Paediatr . 2012;101:1164–1169. doi:10.1111/j.1651-2227.2012.02803.x 22849395
  • Roberts AJ , Taplin CE , Isom S , et al. Association between fear of hypoglycemia and physical activity in youth with type 1 diabetes: the SEARCH for diabetes in youth study. Pediatr Diabetes . 2020;21(7):1277–1284. doi:10.1111/pedi.13092 32738012
  • Taplin CE , Cobry E , Messer L , McFann K , Chase HP , Fiallo-Scharer R . Preventing post-exercise nocturnal hypoglycemia in children with type 1 diabetes. J Pediatr . 2010;157:784–788.e1. doi:10.1016/j.jpeds.2010.06.004 20650471
  • Baker LB , Rollo I , Stein KW , Jeukendrup AE . Acute effects of carbohydrate supplementation on intermittent sports performance. Nutrients . 2015;7:5733–5763. doi:10.3390/nu7075249 26184303
  • Czenczek-Lewandowska E , Grzegorczyk J , Mazur A . Physical activity in children and adolescents with type 1 diabetes and contem-porary methods of its assessment. Pediatr Endocrinol Diabetes Metab . 2018;24(4):179–184. doi:10.5114/pedm.2018.83364 30963755
  • Rubino F , Puhl RM , Cummings DE , et al. Joint international consensus statement for ending stigma of obesity. Nat Med . 2020;26(4):485–497. doi:10.1038/s41591-020-0803-x 32127716
  • Magallares A , Pais-Ribeiro JL . Mental health and obesity: a meta-analysis. Appl Res Qual Life . 2014;9:295–308. doi:10.1080/13548506.2014.963627
  • Wisting L , Skrivarhaug T , Dahl-Jørgensen K , Rø Ø . Prevalence of disturbed eating behavior and associated symptoms of anxiety and depression among adult males and females with type 1 diabetes. J Eat Disord . 2018;6:28. doi:10.1186/s40337-018-0209-z 30214804
  • Young V , Eiser C , Johnson B , et al. Eating problems in adolescents with type 1 diabetes: a systematic review with meta-analysis. Diabet Med . 2013;30:189–198. doi:10.1111/j.1464-5491.2012.03771.x 22913589
  • Palavras MA , Kaio GH , Mari J , Claudino AM . A review of Latin American studies on binge eating disorder. Rev Bras Psiquiatr . 2011;33:s81–s94. doi:10.1590/s1516-44462011000500007 21845337
  • Villarejo C , Fernandez-Aranda F , Jimenez-Murcia S , et al. Lifetime obesity in patients with eating disorders: increasing prevalence, clinical and personality correlates. Eur Eat Disord Rev . 2012;20:250–254. doi:10.1002/erv.2166 22383308
  • Bryden KS , Neil A , Mayou RA , Peveler RC , Fairburn CG , Dunger DB . Eating habits, body weight, and insulin misuse. A longitudinal study of teenagers and young adults with type 1 diabetes. Diabetes Care . 1999;22:1956–1960. doi:10.1002/erv.2166 10587825
  • Pinhas-Hamiel O , Hamiel U , Levy-Shraga Y . Eating disorders in adolescents with type 1 diabetes: challenges in diagnosis and treatment. World J Diabetes . 2015;6:517–526. doi:10.4239/wjd.v6.i3.517 25897361
  • Toni G , Berioli MG , Cerquiglini L , et al. Eating disorders and disordered eating symptoms in adolescents with type 1 diabetes. Nutrients . 2017;9(8):906. doi:10.3390/nu9080906
  • Markowitz JT , Alleyn CA , Phillips R , Muir A , Young-Hyman D , Laffel LM . Disordered eating behaviors in youth with type 1 diabetes: prospective pilot assessment following initiation of insulin pump therapy. Diabetes Technol Ther . 2013;15(5):428–433. doi:10.1089/dia.2013.0008 23550556
  • Rucker D , Padwal R , Li SK , Curioni C , Lau DC . Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ . 2007;335(7631):1194–1199. doi:10.1136/bmj.39385.413113.25 18006966
  • Greenway FL , Fujioka K , Plodkowski RA , et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, Phase 3 trial. Lancet . 2010;376:595–605. doi:10.1016/S0140-6736(10)60888-4 20673995
  • Apovian CM , Aronne L , Rubino D , et al.; COR-II Study Group. A randomized, phase 3 trial of naltrexone SR/bupropion SR on weight and obesity-related risk factors (COR-II). Obesity (Silver Spring) . 2013;21:935–943. doi:10.1002/oby.20309 23408728
  • Wadden TA , Foreyt JP , Foster GD , et al. Weight loss with naltrexone SR/bupropion SR combination therapy as an adjunct to behavior modification: the COR-BMOD trial. Obesity (Silver Spring) . 2011;19:110–120. doi:10.1038/oby.2010.147 20559296
  • Hollander P , Gupta AK , Plodkowski R , et al.; COR-Diabetes Study Group. Effects of naltrexone sustained-release/bupropion sustained-release combination therapy on body weight and glycemic parameters in overweight and obese patients with type 2 diabetes. Diabetes Care . 2013;36(12):4022–4029. doi:10.2337/dc13-0234 24144653
  • Gadde KM , Allison DB , Ryan DH , et al. Effects of low dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial. Lancet . 2011;377(9774):1341–1352. doi:10.1016/S0140-6736(11)60205-5 21481449
  • Allison DB , Gadde KM , Garvey WT , et al. Controlled-release phentermine/topiramate in severely obese adults: a randomized controlled trial (EQUIP). Obesity (Silver Spring) . 2012;20(2):330–342. doi:10.1038/oby.2011.330 22051941
  • Garvey WT , Ryan DH , Look M , et al. Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): a randomized, placebo-controlled, phase 3 extension study. Am J Clin Nutr . 2012;95(2):297–308. doi:10.3945/ajcn.111.024927 22158731
  • Garvey WT , Ryan DH , Bohannon NJ , et al. Weight-loss therapy in type 2 diabetes: effects of phentermine and topiramate extended release. Diabetes Care . 2014;37(12):3309–3316. doi:10.2337/dc14-0930 25249652
  • Pi-Sunyer X , Astrup A , Fujioka K , et al. A Randomized, Controlled Trial of 3.0 mg of liraglutide in weight management. New Engl J Med . 2015;373:11–22. doi:10.1056/NEJMoa1411892 26132939
  • Le Roux CW , Astrup A , Fujioka K , et al. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. Lancet . 2017;389:1399–1409. doi:10.1016/S0140-6736(17)30069-7 28237263
  • Davies MJ , Aronne LJ , Caterson ID , Thomsen AB , Jacobsen PB , Marso SP . Liraglutide and cardiovascular outcomes in adults with overweight or obesity: a post hoc analysis from SCALE randomized controlled trials. Diabetes Obes Metab . 2018;20:734–739. doi:10.1111/dom.13125 28950422
  • Davies MJ , Bergenstal R , Bode B , et al.; NN8022-1922 Study Group. Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE Diabetes Randomized Clinical Trial. JAMA . 2015;314(7):687–699. doi:10.1001/jama.2015.9676 26284720
  • Kelly AS , Auerbach P , Barrientos-Perez M , et al.; NN8022-4180 Trial Investigators. A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity. N Engl J Med . 2020;382(22):2117–2128. doi:10.1056/NEJMoa1916038 32233338
  • Pratley RE , Aroda VR , Lingvay I , et al.; SUSTAIN 7 investigators. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial. Lancet Diabetes Endocrinol . 2018;6(4):275–286. doi:10.1016/S2213-8587(18)30024-X 29397376
  • Wilding JPH , Batterham RL , Calanna S , et al.; STEP 1 Study Group. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med . 2021;384(11):989. doi:10.1056/NEJMoa2032183 33567185
  • Davies M , Færch L , Jeppesen OK , et al.; STEP 2 Study Group. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet . 2021;397(10278):971–984. doi:10.1016/S0140-6736(21)00213-0 33667417
  • Holst JJ , Rosenkilde MM . GIP as a therapeutic target in diabetes and obesity: insight from incretin co-agonists. J Clin Endocrinol Metab . 2020;105(8):e2710–6. doi:10.1210/clinem/dgaa327
  • Rena G , Hardie DG , Pearson ER . The mechanisms of action of metformin. Diabetologia . 2017;60(9):1577–1585. doi:10.1007/s00125-017-4342-z 28776086
  • Jacobsen IB , Henriksen JE , Beck-Nielsen H . The effect of metformin in overweight patients with type 1 diabetes and poor metabolic control. Basic Clin Pharmacol Toxicol . 2009;105(3):145–149. doi:10.1111/j.1742-7843.2009.00380.x 19496776
  • Lund SS , Tarnow L , Astrup AS , et al. Effect of adjunct metformin treatment in patients with type-1 diabetes and persistent inadequate glycaemic control. A randomized study. PLoS One . 2008;3(10):e3363. doi:10.1371/journal.pone.0003363 18852875
  • Petrie JR , Chaturvedi N , Ford I , et al.; REMOVAL Study Group. Cardiovascular and metabolic effects of metformin in patients with type 1 diabetes (REMOVAL): a double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol . 2017;5(8):597–609. doi:10.1016/S2213-8587(17)30194-8 28615149
  • Pörksen S , Nielsen LB , Kaas A , et al.; Hvidøre Study Group on Childhood Diabetes. Meal-stimulated glucagon release is associated with postprandial blood glucose level and does not interfere with glycemic control in children and adolescents with new-onset type 1 diabetes. J Clin Endocrinol Metab . 2007;92(8):2910–2916. doi:10.1210/jc.2007-0244 17519307
  • Griffin KJ , Thompson PA , Gottschalk M , Kyllo JH , Rabinovitch A . Combination therapy with sitagliptin and lansoprazole in patients with recent-onset type 1 diabetes (REPAIR-T1D): 12-month results of a multicentre, randomised, placebo-controlled, Phase 2 trial. Lancet Diabetes Endocrinol . 2014;2(9):710–718. doi:10.1016/S2213-8587(14)70115-9 24997559
  • Ellis SL , Moser EG , Snell-Bergeon JK , Rodionova AS , Hazenfield RM , Garg SK . Effect of sitagliptin on glucose control in adult patients with Type 1 diabetes: a pilot, double-blind, randomized, crossover trial. Diabet Med . 2011;28(10):1176–1181. doi:10.1111/j.1464-5491.2011.03331.x 21923696
  • Traina AN , Lull ME , Hui AC , Zahorian TM , Lyons-Patterson J . Once-weekly exenatide as adjunct treatment of type 1 diabetes mellitus in patients receiving continuous subcutaneous insulin infusion therapy. Can J Diabetes . 2014;38(4):269–272. doi:10.1016/j.jcjd.2013.10.006 24797495
  • Hari Kumar KV , Shaikh A , Prusty P . Addition of exenatide or sitagliptin to insulin in new onset type 1 diabetes: a randomized, open label study. Diabetes Res Clin Pract . 2013;100(2):e55–8. doi:10.1016/j.diabres.2013.01.020 23490599
  • Jiang LL , Wang SQ , Ding B , et al. The effects of add-on exenatide to insulin on glycemic variability and hypoglycemia in patients with type 1 diabetes mellitus. J Endocrinol Invest . 2018;41(5):539–547. doi:10.1007/s40618-017-0765-0 29032494
  • Dejgaard TF , Frandsen CS , Hansen TS , et al. Efficacy and safety of liraglutide for overweight adult patients with type 1 diabetes and insufficient glycaemic control (Lira-1): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol . 2016;4(3):221–232. doi:10.1016/S2213-8587(15)00436-2 26656289
  • Mathieu C , Zinman B , Hemmingsson JU , et al.; ADJUNCT ONE Investigators. Efficacy and safety of liraglutide added to insulin treatment in type 1 diabetes: the ADJUNCT ONE Treat-To-Target Randomized Trial. Diabetes Care . 2016;39(10):1702–1710. doi:10.2337/dc16-0691 27506222
  • Ahrén B , Hirsch IB , Pieber TR , et al.; ADJUNCT TWO Investigators. Efficacy and safety of liraglutide added to capped insulin treatment in subjects with type 1 diabetes: the ADJUNCT TWO Randomized Trial. Diabetes Care . 2016;39(10):1693–1701. doi:10.2337/dc16-0690 27493132
  • Rieg T , Vallon V . Development of SGLT1 and SGLT2 inhibitors. Diabetologia . 2018;61(10):2079–2086. doi:10.1007/s00125-018-4654-7 30132033
  • Dandona P , Mathieu C , Phillip M , et al.; DEPICT-1 Investigators. Efficacy and safety of dapagliflozin in patients with inadequately controlled type 1 diabetes: the DEPICT-1 52-Week Study. Diabetes Care . 2018;41(12):2552–2559. doi:10.2337/dc18-1087 30352894
  • Mathieu C , Dandona P , Gillard P , et al.; DEPICT-2 Investigators. Efficacy and safety of dapagliflozin in patients with inadequately controlled type 1 diabetes (the DEPICT-2 Study): 24-Week Results From a Randomized Controlled Trial. Diabetes Care . 2018;41(9):1938–1946. doi:10.2337/dc18-0623 30026335
  • Pieber TR , Famulla S , Eilbracht J , et al. Empagliflozin as adjunct to insulin in patients with type 1 diabetes: a 4-week, randomized, placebo-controlled trial (EASE-1). Diabetes Obes Metab . 2015;17(10):928–935. doi:10.1111/dom.12494 26080652
  • Rosenstock J , Marquard J , Laffel LM , et al. Empagliflozin as adjunctive to insulin therapy in type 1 diabetes: the EASE Trials. Diabetes Care . 2018;41(12):2560–2569. doi:10.2337/dc18-1749 30287422
  • Buse JB , Garg SK , Rosenstock J , et al. Sotagliflozin in combination with optimized insulin therapy in adults with type 1 diabetes: the North American inTandem1 Study. Diabetes Care . 2018;41(9):1970–1980. doi:10.2337/dc18-0343 29937430
  • Danne T , Cariou B , Banks P , et al. HbA(1c) and hypoglycemia reductions at 24 and 52 weeks with sotagliflozin in combination with insulin in adults with type 1 diabetes: the European inTandem2 Study. Diabetes Care . 2018;41(9):1981–1990. doi:10.2337/dc18-0342 29937431
  • Garg SK , Henry RR , Banks P . Effects of sotagliflozin added to insulin in patients with type 1 diabetes. N Engl J Med . 2017;377(24):2337–2348. doi:10.1056/NEJMoa1708337 28899222
  • Hay DL , Chen S , Lutz TA , Parkes DG , Roth JD . Amylin: pharmacology, physiology, and clinical potential. Pharmacol Rev . 2015;67(3):564–600. doi:10.1124/pr.115.010629 26071095
  • Kruger DF , Gatcomb PM , Owen SK . Clinical implications of amylin and amylin deficiency. Diabetes Educ . 1999;25(3):389–97;quiz 398. doi:10.1177/014572179902500310
  • Whitehouse F , Kruger DF , Fineman M , et al. A randomized study and open-label extension evaluating the long-term efficacy of pramlintide as an adjunct to insulin therapy in type 1 diabetes. Diabetes Care . 2002;25(4):724–730. doi:10.2337/diacare.25.4.724 11919132
  • Edelman S , Garg S , Frias J , et al. A double-blind, placebo-controlled trial assessing pramlintide treatment in the setting of intensive insulin therapy in type 1 diabetes. Diabetes Care . 2006;29(10):2189–2195. doi:10.2337/dc06-0042 17003291
  • Ratner RE , Dickey R , Fineman M , et al. Amylin replacement with pramlintide as an adjunct to insulin therapy improves long-term glycaemic and weight control in Type 1 diabetes mellitus: a 1-year, randomized controlled trial. Diabet Med . 2004;21(11):1204–1212. doi:10.1111/j.1464-5491.2004.01319.x 15498087
  • Watanabe M , Risi R , Masi D , et al. Current evidence to propose different food supplements for weight loss: a comprehensive review. Nutrients . 2020;12(9):2873. doi:10.3390/nu12092873
  • Lin Y , Shi D , Su B , et al. The effect of green tea supplementation on obesity: a systematic review and dose-response meta-analysis of randomized controlled trials. Phytother Res . 2020;34(10):2459–2470. doi:10.1002/ptr.6697 32372444
  • De Luca M , Angrisani L , Himpens J , et al. Indications for surgery for obesity and weight-related diseases: position statements from the International Federation for the Surgery of Obesity and Metabolic Disorders IFSO. Obes Surg . 2016;26:1659–1696. doi:10.1007/s11695-016-2271-4 27412673
  • Korakas E , Kountouri A , Raptis A , Kokkinos A , Lambadiari V . Bariatric surgery and type 1 diabetes: unanswered questions. Front Endocrinol (Lausanne) . 2020;11:525909. doi:10.3389/fendo.2020.525909 33071965
  • Breen DM , Rasmussen BA , Kokorovic A , Wang R , Cheung GW , Lam TK . Jejunal nutrient sensing is required for duodenal-jejunal bypass surgery to rapidly lower glucose concentrations in uncontrolled diabetes. Nat Med . 2012;18(6):950–955. doi:10.1038/nm.2745 22610279
  • Dirksen C , Jacobsen SH , Bojsen-Møller KN , et al. Reduction in cardiovascular risk factors and insulin dose, but no beta-cell regeneration 1 year after Roux-en-Y gastric bypass in an obese patient with type 1 diabetes: a case report. Obes Res Clin Pract . 2013;7(4):e269–74. doi:10.1016/j.orcp.2012.01.002 24306154
  • Blanco J , Jiménez A , Casamitjana R , et al. Relevance of beta-cell function for improved glycemic control after gastric bypass surgery. Surg Obes Relat Dis . 2014;10(1):9–13;quiz 189–90. doi:10.1016/j.soard.2013.07.020
  • Czupryniak L , Strzelczyk J , Cypryk K , et al. Gastric bypass surgery in severely obese type 1 diabetic patients. Diabetes Care . 2004;27(10):2561–2562. doi:10.2337/diacare.27.10.2561 15451938
  • Czupryniak L , Wiszniewski M , Szymański D , Pawłowski M , Loba J , Strzelczyk J . Long-term results of gastric bypass surgery in morbidly obese type 1 diabetes patients. Obes Surg . 2010;20(4):506–508. doi:10.1007/s11695-010-0074-6 20127290
  • Mendez CE , Tanenberg RJ , Pories W . Outcomes of Roux-en-Y gastric bypass surgery for severely obese patients with type 1 diabetes: a case series report. Diabetes Metab Syndr Obes . 2010;3:281–283. PMID: 21437096; PMCID: PMC3047955. doi:10.2147/DMSO.S9981 21437096
  • Fuertes-Zamorano N , Sánchez-Pernaute A , Torres García AJ , Rubio Herrera MA . Bariatric surgery in type 1 diabetes mellitus; long-term experience in two cases. Nutr Hosp . 2013;28(4):1333–1336. doi:10.3305/nh.2013.28.4.6605 23889661
  • Chuang J , Zeller MH , Inge T , Crimmins N . Bariatric surgery for severe obesity in two adolescents with type 1 diabetes. Pediatrics . 2013;132(4):e1031–4. doi:10.1542/peds.2012-3640 24062368
  • Raab H , Weiner RA , Frenken M , Rett K , Weiner S . Obesity and metabolic surgery in type 1 diabetes mellitus. Nutr Hosp . 2013;28(Suppl 2):31–34. doi:10.3305/nh.2013.28.sup2.6711 23834044
  • Middelbeek RJ , James-Todd T , Patti ME , Brown FM . Short-term insulin requirements following gastric bypass surgery in severely obese women with type 1 diabetes. Obes Surg . 2014;24(9):1442–1446. doi:10.1007/s11695-014-1228-8 24668543
  • Brethauer SA , Aminian A , Rosenthal RJ , Kirwan JP , Kashyap SR , Schauer PR . Bariatric surgery improves the metabolic profile of morbidly obese patients with type 1 diabetes. Diabetes Care . 2014;37(3):e51–2. doi:10.2337/dc13-1736 24558084
  • Tang A , Milner KL , Tonks K , Campbell LV , Greenfield JR . Comment on Brethauer et al. Bariatric surgery improves the metabolic profile of morbidly obese patients with type 1 diabetes. Diabetes care 2014;37:e51-e52. Diabetes Care . 2014;37(11):e248–9. doi:10.2337/dc14-0578 25342844
  • Lannoo M , Dillemans B , Van Nieuwenhove Y , et al. Bariatric surgery induces weight loss but does not improve glycemic control in patients with type 1 diabetes. Diabetes Care . 2014;37(8):e173–4. doi:10.2337/dc14-0583 25061146
  • Middelbeek RJ , James-Todd T , Cavallerano JD , Schlossman DK , Patti ME , Brown FM . Gastric bypass surgery in severely obese women with type 1 diabetes: anthropometric and cardiometabolic effects at 1 and 5 years postsurgery. Diabetes Care . 2015;38(7):e104–5. doi:10.2337/dc15-0396 26106230
  • Maraka S , Kudva YC , Kellogg TA , Collazo-Clavell ML , Mundi MS . Bariatric surgery and diabetes: implications of type 1 versus insulin-requiring type 2. Obesity (Silver Spring) . 2015;23(3):552–557. doi:10.1002/oby.20992 25611727
  • Robert M , Belanger P , Hould FS , Marceau S , Tchernof A , Biertho L . Should metabolic surgery be offered in morbidly obese patients with type I diabetes? Surg Obes Relat Dis . 2015;11(4):798–805. doi:10.1016/j.soard.2014.12.016 25868828
  • Landau Z , Kowen-Sandbank G , Jakubowicz D , et al. Bariatric surgery in patients with type 1 diabetes: special considerations are warranted. Ther Adv Endocrinol Metab . 2019;10:2042018818822207. doi:10.1177/2042018818822207 30728940
  • García-Caballero M , Valle M , Martínez-Moreno JM , et al. Resolution of diabetes mellitus and metabolic syndrome in normal weight 24–29 BMI patients with one anastomosis gastric bypass. Nutr Hosp . 2012;27(2):623–631. doi:10.1590/S0212-16112012000200041 22732993
  • Reyes Garcia R , Romero Muñoz M , Galbis Verdú H . Bariatric surgery in type 1 diabetes. Endocrinol Nutr . 2013;60(1):46–47. doi:10.1016/j.endonu.2012.01.021 22520167
  • Moreno-Fernandez J , Chico A . Bariatric surgery results in patients with type 1 diabetes mellitus on continuous subcutaneous insulin infusion therapy. Endocrinol Nutr . 2016;63(10):571–572. doi:10.1016/j.endonu.2016.09.002 27765489
  • Rottenstreich A , Keidar A , Yuval JB , Abu-Gazala M , Khalaileh A , Elazary R . Outcome of bariatric surgery in patients with type 1 diabetes mellitus: our experience and review of the literature. Surg Endosc . 2016;30(12):5428–5433. doi:10.1007/s00464-016-4901-2 27126622
  • Faucher P , Poitou C , Carette C , et al. Bariatric surgery in obese patients with type 1 diabetes: effects on weight loss and metabolic control. Obes Surg . 2016;26(10):2370–2378. doi:10.1007/s11695-016-2106-3 26886929
  • Al Sabah S , Al Haddad E , Muzaffar TH , Almulla A . Laparoscopic sleeve gastrectomy for the management of type 1 diabetes mellitus. Obes Surg . 2017;27(12):3187–3193. doi:10.1007/s11695-017-2777-4 28653181
  • Vilarrasa N , Rubio MA , Miñambres I , et al. Long-term outcomes in patients with morbid obesity and type 1 diabetes undergoing bariatric surgery. Obes Surg . 2017;27(4):856–863. doi:10.1007/s11695-016-2390-y 27709487
  • Mahawar KK , De Alwis N , Carr WR , Jennings N , Schroeder N , Small PK . Bariatric surgery in type 1 diabetes mellitus: a systematic review. Obes Surg . 2016;26(1):196–204. doi:10.1007/s11695-015-1924-z 26452482
  • Kirwan JP , Aminian A , Kashyap SR , Burguera B , Brethauer SA , Schauer PR . Bariatric surgery in obese patients with type 1 diabetes. Diabetes Care . 2016;39(6):941–948. doi:10.2337/dc15-2732 27222552
  • Ashrafian H , Harling L , Toma T , et al. Type 1 diabetes mellitus and bariatric surgery: a systematic review and meta-analysis. Obes Surg . 2016;26(8):1697–1704. doi:10.1007/s11695-015-1999-6 26694210
  • Chow A , Switzer NJ , Dang J , et al. A systematic review and meta-analysis of outcomes for type 1 diabetes after bariatric surgery. J Obes . 2016;2016:6170719. doi:10.1155/2016/6170719 27375900
  • Hussain A . The effect of metabolic surgery on type 1 diabetes: meta-analysis. Arch Endocrinol Metab . 2018;62(2):172–178. doi:10.20945/2359-3997000000021 29641734
  • Hanaire H , Bertrand M , Guerci B , Anduze Y , Guillaume E , Ritz P . High glycemic variability assessed by continuous glucose monitoring after surgical treatment of obesity by gastric bypass. Diabetes Technol Ther . 2011;13(6):625–630. doi:10.1089/dia.2010.0203 21488800
  • Höskuldsdóttir G , Ekelund J , Miftaraj M , et al. Potential benefits and harms of gastric bypass surgery in obese individuals with type 1 diabetes: a Nationwide, Matched, Observational Cohort Study. Diabetes Care . 2020;43(12):3079–3085. doi:10.2337/dc20-0388 33023988
  • Aminian A , Kashyap SR , Burguera B , et al. Incidence and clinical features of diabetic ketoacidosis after bariatric and metabolic surgery. Diabetes Care . 2016;39(4):e50–3. doi:10.2337/dc15-2647 26822327
  • Liakopoulos V , Franzén S , Svensson AM , et al. Pros and cons of gastric bypass surgery in individuals with obesity and type 2 diabetes: nationwide, matched, observational cohort study. BMJ Open . 2019;9(1):e023882. doi:10.1136/bmjopen-2018-023882
  • Wu P , Liu Z , Jiang X , Fang H . An overview of prospective drugs for type 1 and type 2 diabetes. Curr Drug Targets . 2020;21(5):445–457. doi:10.2174/1389450120666191031104653 31670620
  • Ye X , Qi J , Wu Q , et al. Long-lasting hypoglycemic effect of modified FGF-21 analog with polyethylene glycol in type 1 diabetic mice and its systematic toxicity. Eur J Pharmacol . 2016;781:198–208. doi:10.1016/j.ejphar.2016.04.025 27089817
  • Xie X , Yan D , Li H , et al. Enhancement of adiponectin ameliorates nonalcoholic fatty liver disease via inhibition of foxo1 in type i diabetic rats. J Diabetes Res . 2018;2018:6254340. doi:10.1155/2018/6254340 30186875
  • Vallianou NG , Stratigou T , Geladari E , Tessier CM , Mantzoros CS , Dalamaga M . Diabetes type 1: can it be treated as an autoimmune disorder? Rev Endocr Metab Disord . 2021. doi:10.1007/s11154-021-09642-4
  • Pourrajab B , Fatahi S , Sohouli MH , Găman MA , Shidfar F . The effects of probiotic/synbiotic supplementation compared to placebo on biomarkers of oxidative stress in adults: a systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr . 2020;4:1–18. doi:10.1080/10408398.2020.1821166
  • Sohouli MH , Fatahi S , Sharifi-Zahabi E , et al. The impact of low advanced glycation end products diet on metabolic risk factors: a Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr . 2020:nmaa150. doi:10.1093/advances/nmaa150
  • Enebo LB , Berthelsen KK , Kankam M , et al. Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2·4 mg for weight management: a randomised, controlled, phase 1b trial. Lancet . 2021;397(10286):1736–1748. doi:10.1016/S0140-6736(21)00845-X 33894838
  • Heymsfield SB , Coleman LA , Miller R , et al. Effect of bimagrumab vs placebo on body fat mass among adults with type 2 diabetes and obesity: a Phase 2 Randomized Clinical Trial. JAMA Netw Open . 2021;4(1):e2033457. doi:10.1001/jamanetworkopen.2020.33457 33439265
  • Battaglia M , Ahmed S , Anderson MS , et al. Introducing the endotype concept to address the challenge of disease heterogeneity in type 1 diabetes. Diabetes Care . 2020;43(1):5–12. doi:10.2337/dc19-0880 31753960