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Weight Management in Youth with Type 1 Diabetes and Obesity: Challenges and Possible Solutions
Dessi P Zaharieva1, Ananta Addala2, Kimber M Simmons3
1Division of Endocrinology, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA. dessi@stanford.edu.
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. 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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