Journal of diabetes investigationSep 1, 2026

Type 1 Diabetes and Obesity: How They Affect the Body and Treatment Options

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Sep 2, 2026

Abstract

Overweight and obesity are now common in type 1 diabetes, increasing the risk of various health complications.

Individuals with type 1 diabetes may experience high insulin requirements, hypertension, and dyslipidemia due to obesity.
The combination of type 1 and type 2 diabetes characteristics has been referred to as double diabetes, though this is a descriptive term.
Potential contributors to insulin resistance in type 1 diabetes include intensive insulin therapy, genetic factors, and inflammation.
Clinical consequences of this condition may involve metabolic syndrome and increased cardiovascular and renal risks.
Treatment options under consideration include amylin replacement and incretin receptor agonists.

Simplified

Type 1 diabetes is defined by immune-mediated beta-cell failure and dependence on exogenous insulin. That definition is correct, but it may not fully describe many people seen in current clinical practice. Overweight and obesity are now common in type 1 diabetes, leading to variable combinations of high insulin requirement, hypertension, dyslipidemia, metabolic syndrome, metabolic dysfunction-associated steatotic liver disease (MASLD), and increased cardiovascular and renal risk. These features have been termed double diabetes, but that term is descriptive rather than mechanistic. The overlap between type 1 and type 2 diabetes features may reflect overweight or obesity, effects of intensive insulin therapy (with treatment-related hyperinsulinemia leading to disproportionate peripheral vs. hepatic insulin action), inherited or environmental factors leading to insulin resistance, glucagon dysregulation, ectopic fat, and inflammation. This review summarizes the epidemiology, pathophysiology, clinical consequences, and therapeutic implications of insulin-resistant type 1 diabetes, reviewing the established precedent of amylin replacement and potential treatments including incretin receptor agonists and next-generation amylin receptor agonists.

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Type 1 Diabetes and Obesity: How They Affect the Body and Treatment Options

Abstract

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