medwireNews: There is a “substantial” burden of overweight and obesity among people with type 1 diabetes, say US researchers who found rates to be in line with that of the general population.
“Our study provides the first population-based estimates for U.S. adults, extending the generalizability of [previous] findings to the general population,” write Michael Fang (Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland) in the Annals of Internal Medicine.
The team studied 128,571 US citizens who participated in the nationally representative National Health Interview Survey (NHIS) in the years 2016, 2017, 2019, 2020, or 2021.
The rates of overweight and obesity were 34% and 28%, respectively, among the 733 people with type 1 diabetes, which were similar to the rates of 36% and 28%, respectively, among the 115,441 without diabetes.
People with type 2 diabetes had a similar rate of overweight, at 34%, but a higher rate of obesity, at 52%.
However, the researchers stress that only about half of study participants with overweight or obesity “received lifestyle recommendations from providers or engaged in lifestyle modification.”
In this subgroup, people who had type 1 diabetes were more likely than those who did not to receive dietary and lifestyle advice, at adjusted rates of 51% versus 41% for dietary advice and 54% versus 44% for physical activity recommendations.
Such advice was more readily given to people with type 2 diabetes, at a corresponding 60% for both diet and lifestyle guidance. But regardless of advice received, only 52–63% of people were attempting to improve their lifestyle.
Fang and team observe that addressing overweight and obesity in people with type 1 diabetes is “complicated by insulin use,” because of the necessity for dose and timing adjustments to prevent hypoglycemia.
They add that evidence-based recommendations are “sparse,” and may contribute to the lack of action on lifestyle changes among many people with type 1 diabetes and their healthcare providers.
“The development of more comprehensive clinical guidelines, with an emphasis on individualized patient education, may improve weight management in these patients,” the team concludes.
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