1型糖尿病合并肥胖青少年的体重管理：挑战与可能的解决方案
Weight Management in Youth with Type 1 Diabetes and Obesity: Challenges and Possible Solutions.
作者信息
Zaharieva Dessi P, Addala Ananta, Simmons Kimber M, Maahs David M
机构信息
Division of Endocrinology, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA.
Barbara Davis Center for Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
出版信息
Curr Obes Rep. 2020 Dec;9(4):412-423. doi: 10.1007/s13679-020-00411-z. Epub 2020 Oct 27.
Abstract
PURPOSE OF REVIEW
This review highlights challenges associated with weight management in children and adolescents with type 1 diabetes (T1D). Our purpose is to propose potential solutions to improve weight outcomes in youth with T1D.
RECENT FINDINGS
A common barrier to weight management in T1D is reluctance to engage in exercise for fear of hypoglycemia. Healthcare practitioners generally provide limited guidance for insulin dosing and carbohydrate modifications to maintain stable glycemia during exercise. Adherence to dietary guidelines is associated with improved glycemia; however, youth struggle to meet recommendations. When psychosocial factors are addressed in combination with glucose trends, this often leads to successful T1D management. Newer medications also hold promise to potentially aid in glycemia and weight management, but further research is necessary. Properly addressing physical activity, nutrition, pharmacotherapy, and psychosocial factors while emphasizing weight management may reduce the likelihood of obesity development and its perpetuation in this population.
摘要
综述目的
本综述重点介绍了1型糖尿病（T1D）儿童和青少年体重管理所面临的挑战。我们的目的是提出潜在的解决方案，以改善T1D青少年的体重状况。
最新发现
T1D体重管理的一个常见障碍是因担心低血糖而不愿进行运动。医疗从业者通常在胰岛素剂量调整和碳水化合物摄入调整方面提供有限的指导，以在运动期间维持稳定的血糖水平。遵守饮食指南与改善血糖水平相关；然而，青少年难以达到相关建议。当心理社会因素与血糖趋势相结合进行处理时，这通常会带来成功的T1D管理。新型药物也有望潜在地帮助控制血糖和体重管理，但仍需进一步研究。在强调体重管理的同时，妥善处理身体活动、营养、药物治疗和心理社会因素，可能会降低该人群肥胖发生及其持续存在的可能性。
相似文献
1
Weight Management in Youth with Type 1 Diabetes and Obesity: Challenges and Possible Solutions.1型糖尿病合并肥胖青少年的体重管理：挑战与可能的解决方案
Curr Obes Rep. 2020 Dec;9(4):412-423. doi: 10.1007/s13679-020-00411-z. Epub 2020 Oct 27.
2
An Overview of Diet and Physical Activity for Healthy Weight in Adolescents and Young Adults with Type 1 Diabetes: Lessons Learned from the ACT1ON Consortium.《1 型糖尿病青少年和年轻成人健康体重的饮食和身体活动概述：ACT1ON 联盟的经验教训》。
Nutrients. 2023 May 27;15(11):2500. doi: 10.3390/nu15112500.
3
Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline.孕前糖尿病与妊娠：内分泌学会和欧洲内分泌学会联合临床实践指南
Eur J Endocrinol. 2025 Jun 30;193(1):G1-G48. doi: 10.1093/ejendo/lvaf116.
4
Design of the Advancing Care for Type 1 Diabetes and Obesity Network energy metabolism and sequential multiple assignment randomized trial nutrition pilot studies: An integrated approach to develop weight management solutions for individuals with type 1 diabetes.推进 1 型糖尿病和肥胖症网络能量代谢和序贯多分配随机试验营养先导研究的设计：一种为 1 型糖尿病患者开发体重管理解决方案的综合方法。
Contemp Clin Trials. 2022 Jun;117:106765. doi: 10.1016/j.cct.2022.106765. Epub 2022 Apr 20.
5
Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline.糖尿病合并妊娠：内分泌学会与欧洲内分泌学会联合临床实践指南
J Clin Endocrinol Metab. 2025 Jul 13. doi: 10.1210/clinem/dgaf288.
6
Association between fear of hypoglycemia and physical activity in youth with type 1 diabetes: The SEARCH for diabetes in youth study.1 型糖尿病青少年中低血糖恐惧与身体活动的关系：青少年糖尿病研究（SEARCH）。
Pediatr Diabetes. 2020 Nov;21(7):1277-1284. doi: 10.1111/pedi.13092. Epub 2020 Aug 18.
7
Titration of Long-Acting Insulin Using Continuous Glucose Monitoring and Smart Insulin Pens in Type 1 Diabetes: A Model-Based Carbohydrate-Free Approach.1 型糖尿病中使用连续血糖监测和智能胰岛素笔进行长效胰岛素滴定：一种基于模型的无碳水化合物方法。
Front Endocrinol (Lausanne). 2022 Jan 10;12:795895. doi: 10.3389/fendo.2021.795895. eCollection 2021.
8
Telemedicine in Improving Glycemic Control Among Children and Adolescents With Type 1 Diabetes Mellitus: Systematic Review and Meta-Analysis.远程医疗在改善 1 型糖尿病患儿血糖控制中的应用：系统评价和荟萃分析。
J Med Internet Res. 2024 Jul 9;26:e51538. doi: 10.2196/51538.
9
The Changing Epidemiology of Type 1 Diabetes: A Global Perspective.1型糖尿病不断变化的流行病学：全球视角
Diabetes Obes Metab. 2025 Jun 19. doi: 10.1111/dom.16501.
10
Effects of educational and psychosocial interventions for adolescents with diabetes mellitus: a systematic review.针对青少年糖尿病患者的教育和心理社会干预措施的效果：一项系统评价
Health Technol Assess. 2001;5(10):1-79. doi: 10.3310/hta5100.
引用本文的文献
1
The Interplay between Dietary Habits and Glycemic Control in Type 1 Diabetes: A Comprehensive Prospective FGM Study.1型糖尿病患者饮食习惯与血糖控制之间的相互作用：一项全面的前瞻性连续血糖监测研究
Life (Basel). 2024 Sep 12;14(9):1153. doi: 10.3390/life14091153.
2
Role and Perspective of Certified Diabetes Care and Education Specialists in the Development of the 4T Program.认证糖尿病护理与教育专家在4T项目开发中的角色与视角
Diabetes Spectr. 2024 Spring;37(2):153-159. doi: 10.2337/ds23-0010. Epub 2024 Jan 19.
3
Dietary Factors Associated with Glycemic Control in Children and Adolescents with Type 1 Diabetes.饮食因素与 1 型糖尿病患儿和青少年的血糖控制相关。
Curr Pediatr Rev. 2024;21(1):29-39. doi: 10.2174/1573396320666230822095948.
4
An Overview of Diet and Physical Activity for Healthy Weight in Adolescents and Young Adults with Type 1 Diabetes: Lessons Learned from the ACT1ON Consortium.《1 型糖尿病青少年和年轻成人健康体重的饮食和身体活动概述：ACT1ON 联盟的经验教训》。
Nutrients. 2023 May 27;15(11):2500. doi: 10.3390/nu15112500.
5
The impact of physical activity, quality of life and eating habits on cardiometabolic profile and adipokines in youth with T1D.体育活动、生活质量和饮食习惯对 T1D 青少年心脏代谢特征和脂肪因子的影响。
Endocrine. 2023 Jun;80(3):541-551. doi: 10.1007/s12020-023-03370-2. Epub 2023 Apr 21.
6
Weight Management Behaviors are Associated with Elevated Glycemic Outcomes in Adolescents and Young Adults with Type 1 Diabetes.体重管理行为与 1 型糖尿病青少年和年轻成人的高血糖结局相关。
J Clin Psychol Med Settings. 2023 Dec;30(4):876-883. doi: 10.1007/s10880-023-09936-6. Epub 2023 Feb 2.
7
Body mass index, basal insulin and glycemic control in children with type 1 diabetes treated with the advanced hybrid closed loop system remain stable - 1-year prospective, observational, two-center study.采用先进的混合闭环系统治疗的 1 型糖尿病儿童的体重指数、基础胰岛素和血糖控制保持稳定-1 年前瞻性、观察性、两中心研究。
Front Endocrinol (Lausanne). 2022 Oct 11;13:1036808. doi: 10.3389/fendo.2022.1036808. eCollection 2022.
8
Multi-Faceted Influence of Obesity on Type 1 Diabetes in Children - From Disease Pathogenesis to Complications.肥胖症对儿童 1 型糖尿病的多方面影响——从疾病发病机制到并发症。
Front Endocrinol (Lausanne). 2022 Jun 16;13:890833. doi: 10.3389/fendo.2022.890833. eCollection 2022.
9
Current and Novel Strategies to Reduce Fear of Hypoglycemia as a Barrier to Physical Activity in Adults and Youth With Type 1 Diabetes.降低低血糖恐惧作为1型糖尿病成人和青少年身体活动障碍的当前及新策略
Can J Diabetes. 2022 Feb;46(1):1-2. doi: 10.1016/j.jcjd.2021.12.004.
10
Beyond Two Cultures: Cultural Infrastructure for Data-driven Decision Support.超越两种文化：数据驱动决策支持的文化基础设施
Obs Stud. 2021 Jul;7(1):77-94. doi: 10.1353/obs.2021.0024.
本文引用的文献
1
Glucose Control During Physical Activity and Exercise Using Closed Loop Technology in Adults and Adolescents with Type 1 Diabetes.闭环技术在 1 型糖尿病成人和青少年运动和锻炼期间的血糖控制。
Can J Diabetes. 2020 Dec;44(8):740-749. doi: 10.1016/j.jcjd.2020.06.003. Epub 2020 Jun 8.
2
Strategies That Adolescents With Type 1 Diabetes Use in Relation to Exercise.1型糖尿病青少年在运动方面所采用的策略。
Clin Diabetes. 2020 Jul;38(3):266-272. doi: 10.2337/cd19-0196.
3
Exercise in the treatment of childhood obesity.运动在儿童肥胖治疗中的应用。
Turk Pediatri Ars. 2020 Mar 9;55(1):2-10. doi: 10.14744/TurkPediatriArs.2019.60430. eCollection 2020.
4
A randomised controlled study of high intensity exercise as a dishabituating stimulus to improve hypoglycaemia awareness in people with type 1 diabetes: a proof-of-concept study.一项随机对照研究，探讨高强度运动作为一种脱敏刺激，改善 1 型糖尿病患者的低血糖意识：一项概念验证研究。
Diabetologia. 2020 Apr;63(4):853-863. doi: 10.1007/s00125-019-05076-5. Epub 2020 Jan 15.
5
Type 1 Diabetes and Physical Exercise: Moving (forward) as an Adjuvant Therapy.1 型糖尿病与体育锻炼：作为辅助疗法的运动（疗法）。
Curr Pharm Des. 2020;26(9):946-957. doi: 10.2174/1381612826666200108113002.
6
13. Children and Adolescents: .儿童和青少年： 。
Diabetes Care. 2020 Jan;43(Suppl 1):S163-S182. doi: 10.2337/dc20-S013.
7
7. Diabetes Technology: .7. 糖尿病技术：。
Diabetes Care. 2020 Jan;43(Suppl 1):S77-S88. doi: 10.2337/dc20-S007.
8
5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: .5. 促进行为改变和幸福感以改善健康结果：。
Diabetes Care. 2020 Jan;43(Suppl 1):S48-S65. doi: 10.2337/dc20-S005.
9
Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants.全球青少年身体活动不足趋势：298 项基于人群调查的汇总分析，涉及 160 万参与者。
Lancet Child Adolesc Health. 2020 Jan;4(1):23-35. doi: 10.1016/S2352-4642(19)30323-2. Epub 2019 Nov 21.
10
Physical activity and academic achievements.体育活动与学业成绩。
Acta Paediatr. 2020 Jan;109(1):14-16. doi: 10.1111/apa.15052. Epub 2019 Nov 6.
Zotero 插件