علاج السمنة غير المحددة في داء السكري من النوع 1

References

DOI: 10.2337/dc26-S008

• Apply obesity management strategies used in the general adult population, including GLP-1 RA–based therapy B and metabolic surgery, C to adults with type 1 diabetes who have obesity (BMI ≥30.0 kg/m2, or ≥27.5 kg/m2 in Asian American individuals).
• For treatment of obesity in people with type 1 diabetes, initiation of GLP-1 RA or dual GIP and GLP-1 RA should follow a detailed review of the drug side effect profiles and a person-centered dialogue about goals and expectations.
• Dose escalation protocols validated in people with type 2 diabetes should not be extrapolated to people with type 1 diabetes, for whom titration of GLP-1 RA–based therapy should be particularly cautious and accompanied by close monitoring of changes in insulin requirements and in the frequency of episodes of hypoglycemia.
• It is essential to counsel people with type 1 diabetes who start treatment with a GLP-1 RA or a dual GIP and GLP-1 RA on anticipating an increased risk of hypoglycemia and a reduction in insulin requirements, on maintaining a critical carbohydrate intake, and on testing for excess ketone body production.