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Biopsychosocial Aspects of Weight Management in Type 1 Diabetes: a Review and Next Steps

  • Psychosocial Aspects (S Jaser, Section Editor)
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Abstract

Purpose of Review

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.

Recent Findings

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.

Summary

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.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Acknowledgments

We would like to thank an anonymous reviewer whose comments were especially helpful to improve this paper.

Members of the consortium for the Advancing Care for Type 1 Diabetes and Obesity Network (ACT1ON) include the following: University of Colorado Denver Barbara Davis Center: Franziska K. Bishop, MS and Kimberly A. Driscoll, PhD; Stanford University Division of Endocrinology: David M. Maahs, MD; Korey K. Hood, PhD; and Laya Ekhlaspour, MD; Florida Hospital Translational Research Institute for Metabolism and Diabetes: Christopher Bock, MS; Karen Corbin, PhD, RD; Christopher Davis, PhD; Richard Pratley, MD; Steven R. Smith, MD; and Keri Whitaker, RN, CCRP; North Carolina State University: Eric Laber, PhD; UNC Chapel Hill, Glillings School of Global Public Health, Departments of Nutrition: Anna Kahkoska; Michael R. Kosorok, PhD; Elizabeth Mayer-Davis, PhD; and Joan Thomas, MS, RD; Boston Children’s Hospital: Garry Steil, PhD; York University School of Kinesiology and Health Science: Michael Riddell, PhD.

Advancing Care for Type 1 Diabetes and Obesity Network (ACT1ON) is a consortium of clinical, behavioral, and basic scientists comprising expertise in endocrinology, epidemiology, nutrition, exercise physiology, clinical psychology, and biostatistics from multiple institutions led by the University of North Carolina, Stanford, University of Colorado and the Florida Hospital Translational Medicine Research Institute. ACT1ON aims to elucidate drivers of overweight and obesity in youth and adults with type 1 diabetes. The overarching goal of ACT1ON is to develop evidence-based guidelines for individuals with type 1 diabetes and their diabetes care team regarding weight management and weight loss.

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Authors and Affiliations

  1. Barbara Davis Center for Diabetes, University of Colorado Denver, 1775 Aurora Ct, Aurora, CO, 80045, USA

    Kimberly A. Driscoll & Franziska K. Bishop

  2. Florida Hospital Translational Research Institute for Metabolism and Diabetes, 301 East Princeton Street, Orlando, FL, 32804, USA

    Karen D. Corbin & Richard Pratley

  3. Division of Endocrinology, Department of Pediatrics, Stanford University, 300 Pasteur Dr, Stanford, CA, 94305, USA

    David M. Maahs & Korey K. Hood

  4. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA

    Anna Kahkoska

  5. Department of Nutrition, The University of North Carolina Chapel Hill, Chapel Hill, NC, 27599-7461, USA

    Elizabeth Mayer-Davis

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  3. David M. Maahs
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  4. Richard Pratley
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  5. Franziska K. Bishop
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  6. Anna Kahkoska
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  7. Korey K. Hood
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  8. Elizabeth Mayer-Davis
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Consortia

on behalf of the Advancing Care for Type 1 Diabetes and Obesity Network (ACT1ON)

  • Franziska Bishop
  • , Kimberly Driscoll
  • , David Maahs
  • , Korey Hood
  • , Laya Ekhlaspour
  • , Christopher Bock
  • , Karen Corbin
  • , Christopher Davis
  • , Richard Pratley
  • , Steven R. Smith
  • , Keri Whitaker
  • , Eric Laber
  • , Anna Kahkoska
  • , Michael R. Kosorok
  • , Elizabeth Mayer-Davis
  • , Joan Thomas
  • , Garry Steil
  •  & Michael Riddell

Corresponding author

Correspondence to Kimberly A. Driscoll.

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Conflict of Interest

Kimberly A. Driscoll, Karen D. Corbin, Franziska Bishop, Anna Kahkoska, Korey K. Hood, and Elizabeth Mayer-Davis declare that they have no conflict of interest.

David M. Maahs reports being on the advisory board for Insulet and a consultant for Abbott; and receiving grants from Medtronic, Dexcom, Roche, and Bigfoot Biomedical.

Richard Pratley has received research grants from Gilead Sciences, Lexicon Pharmaceuticals, Ligand Pharmaceuticals, Inc., Lilly, Merck, Novo-Nordisk, Sanofi-Aventic US, LLC, and Takeda; speaker honorarium from AstraZeneca Novo-Nordisk, Takeda; and consultant fees from AstraZeneca, Boehringer-Ingelheim, Eisai, Inc., GlaxoSmithKline, Hanmi Pharmaceutical Co., Ltd., Janssen Scientific Affairs, LLC, Ligand Pharmaceuticals, Inc., Lilly, Merck, Novo-Nordisk, Pfizer, Takeda, and Eisai, Inc.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Psychosocial Aspects

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Driscoll, K.A., Corbin, K.D., Maahs, D.M. et al. Biopsychosocial Aspects of Weight Management in Type 1 Diabetes: a Review and Next Steps. Curr Diab Rep 17, 58 (2017). https://doi.org/10.1007/s11892-017-0892-1

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  • DOI: https://doi.org/10.1007/s11892-017-0892-1

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