Weight Problems Affect Americans With T1D Almost as Often as General Population

Findings highlight the need for evidence-based strategies to avoid being obese or overweight for patients with type 1 diabetes, which is often considered a disease of thin individuals.

Americans with type 1 diabetes (T1D) were obese or overweight at almost the same high rates observed in individuals without diabetes, according to the results of a new study from Johns Hopkins Bloomberg School of Public Health.

Investigators found that approximately 62% of adults with T1D in a national sample were obese or overweight compared with 64% of individuals without diabetes and 86% with type 2 diabetes (T2D).

“The lack of evidence for safe, effective methods of diet- and exercise-based weight control in [individuals with T1D] may be keeping [physicians] from recommending such methods,” Michael Fang, PhD, MHS, an assistant professor in the Department of Epidemiology at the Bloomberg School, said in a statement. “Large clinical trials have been done in [individuals with T2D] to establish guidelines for diet- and exercise-based weight management, and we now need something similar for [individuals with T1D.]”

Investigators also found that half of individuals with T1D who were obese or overweight received lifestyle recommendations from health care providers or engaged in lifestyle intervention to control their weight.

They thought this was likely because the insulin required to treat T1D could cause hypoglycemia, dangerously low blood sugar levels, if combined with intense exercise or severely reduced calorie intake.

Unlike T2D, which is common in individuals who are obese or overweight, T1D is an autoimmune condition that commonly develops in childhood.

The disease occurs when an individual’s immune system attacks and destroys pancreatic cells that produce insulin, rendering them unable to produce adequate levels of insulin on their own.

Being obese or overweight can increase the risk of a wide range of health conditions, including cancer, heart attacks, and strokes. Those with T1D could face additional risks, such as making the body less sensitive to insulin, which could mean that they must inject insulin in higher doses or less predictable blood glucose responses.

Investigators examined data from 2016 through 2021 on 128,571 individuals from the National Health Interview Survey, an annual nationwide survey of the US population on health-related topics.

Approximately 28% of adults with T1D were obese and 34% were overweight compared with 28% and 36% for those without diabetes, respectively.

Individuals with T2D reported receiving lifestyle change advice and implementing those changes at approximately 60% compared with 51% of those with T1D.

“Our study busts the myth that [individuals with T1D] are not being affected by the global obesity epidemic,” Elizabeth Selvin, PhD, MPH, a professor in the Department of Epidemiology at the Bloomberg School, said in the statement. “These findings should be a wake-up call that we need to be aggressive in addressing the obesity epidemic in persons with [T1D].”

The study, which was published in Annals of Internal Medicine, is thought to be the first to estimate the prevalence of obesity for Americans who have T1D.


Overweight and obesity in people with type 1 diabetes nearly same as general population. Eurekalert. News release. February 13, 2023. Accessed February 14, 2023. https://www.eurekalert.org/news-releases/979310

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