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September 3, 2026Journal of Diabetes InvestigationOpen Access

Type 1 diabetes in the era of obesity: Pathophysiology and therapeutic implications

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Authors

ZBZachary T. BloomgardenIcahn School of Medicine at Mount Sinai

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Implication

Review demonstrates the pathophysiology and emerging therapies for obesity and insulin resistance in type 1 diabetes, suggesting potential benefits of incretin and amylin therapies.

Key Points

  • To review the epidemiology, underlying mechanisms, and emerging treatment options for obesity and insulin resistance in patients with type 1 diabetes.
  • Synthesized clinical and mechanistic literature regarding overweight, obesity, and insulin resistance within type 1 diabetes populations.
  • Evaluated the therapeutic evidence for established amylin replacement and emerging non-insulin agents, including incretin and next-generation amylin receptor agonists.
  • Obesity in type 1 diabetes elevates the risks of hypertension, dyslipidemia, metabolic dysfunction-associated steatotic liver disease, and cardiorenal disease.
  • Underlying mechanisms include treatment-related hyperinsulinemia, ectopic fat deposition, peripheral insulin resistance, systemic inflammation, and glucagon dysregulation.
  • Non-insulin therapies, particularly incretin receptor agonists and amylin analogues, offer targeted strategies to reduce excessive insulin requirements and metabolic complications.

Cite This Study

Zachary T. Bloomgarden (2026) studied this question.

synapsesocial.com/papers/6a9935e5636c6408cfa7e796https://doi.org/10.1111/jdi.70427
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