Obesity Complicating Pediatric Type 1 Diabetes: Mechanistic Links, Clinical Assessment, and Therapeutic Challenges
DOI:
https://doi.org/10.48047/hg3hhz57Keywords:
type 1 diabetes; pediatric obesity; insulin resistance; double diabetes; cardiometabolic risk; adjunctive therapyAbstract
Background: The coexistence of obesity and type 1 diabetes (T1D) in childhood has evolved from an apparent paradox into a common and
clinically important phenotype. Excess adiposity may precede diagnosis, emerge during pubertal development, or follow insulin initiation and modern intensive diabetes management. In a child who depends on exogenous insulin, weight gain and insulin resistance form a bidirectional cycle: higher insulin exposure can favor energy storage, while adipose dysfunction, ectopic lipid deposition, inflammation, and pubertal hormonal changes increase insulin requirements. This phenotype, often described as double diabetes
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References
American Diabetes Association Professional Practice Committee for Diabetes. 14. Children and adolescents: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S297-S320.
Ogle GD, James S, Dabelea D, et al. Global estimates of incidence of type 1 diabetes in children and adolescents: results from the International Diabetes Federation Atlas. Diabetes Res Clin Pract. 2022;183:109083.
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