Driscoll Kimberly A, Corbin Karen D, Maahs David M, Pratley Richard, Bishop Franziska K, Kahkoska Anna, Hood Korey K, Mayer-Davis Elizabeth
Barbara Davis Center for Diabetes, University of Colorado Denver, 1775 Aurora Ct, Aurora, CO, 80045, USA.
Florida Hospital Translational Research Institute for Metabolism and Diabetes, 301 East Princeton Street, Orlando, FL, 32804, USA.
Curr Diab Rep. 2017 Aug;17(8):58. doi: 10.1007/s11892-017-0892-1.
This review aims to summarize the type 1 diabetes (T1D) and weight literature with an emphasis on barriers associated with weight management, the unique T1D-specific factors that impact weight loss success, maladaptive and adaptive strategies for weight loss, and interventions to promote weight loss.
Weight gain is associated with intensive insulin therapy. Overweight and obese weight status in individuals with T1D is higher than the general population and prevalence is rising. A variety of demographic (e.g., female sex), clinical (e.g., greater insulin needs), environmental (e.g., skipping meals), and psychosocial (e.g., depression, stress) factors are associated with overweight/obese weight status in T1D. Fear of hypoglycemia is a significant barrier to engagement in physical activity. Studies evaluating adaptive weight loss strategies in people with T1D are limited. There is a growing literature highlighting the prevalence and seriousness of overweight and obesity among both youth and adults with T1D. There is an urgent need to develop evidence-based weight management guidelines and interventions that address the unique concerns of individuals with T1D and that concurrently address glycemic control.
本综述旨在总结1型糖尿病（T1D）与体重相关文献，重点关注与体重管理相关的障碍、影响减肥成功的独特的T1D特异性因素、减肥的适应不良和适应策略以及促进减肥的干预措施。
体重增加与强化胰岛素治疗有关。T1D患者的超重和肥胖体重状况高于一般人群，且患病率正在上升。多种人口统计学因素（如女性）、临床因素（如胰岛素需求量更大）、环境因素（如不吃饭）和心理社会因素（如抑郁、压力）与T1D患者的超重/肥胖体重状况有关。对低血糖的恐惧是参与体育活动的一个重大障碍。评估T1D患者适应性减肥策略的研究有限。越来越多的文献强调了T1D青少年和成年人中超重和肥胖的患病率及严重性。迫切需要制定基于证据的体重管理指南和干预措施，以解决T1D患者的独特问题，并同时解决血糖控制问题。
