title: [Influence of body weight on the natural history of and the therapeutic approaches to type 1 diabetes].
abstract: 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.
authors.affiliation: Service de Diabétologie, Nutrition et Maladies métaboliques et Unité de Pharmacologie clinique, Département de Médecine, CHU de Liège, Belgique.
authors.forename: M
authors.initials: M
authors.lastname: Franck
authors.forename: N
authors.initials: N
authors.lastname: Paquot
authors.forename: A J
authors.initials: AJ
authors.lastname: Scheen
mesh_terms: D000293:Adolescent; D050110:Bariatric Surgery; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D024821:Metabolic Syndrome / Q000188:drug therapy / Q000503:physiopathology; D009765:Obesity / Q000503:physiopathology* / Q000601:surgery; D012307:Risk Factors
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin