This protocol covers a specific clinical population: adults with type 1 diabetes who also have obesity, defined as BMI ≥30.0 kg/m² (or ≥27.5 kg/m² in Asian American individuals). Managing obesity in this setting requires approaches adapted to the particular metabolic context of type 1 diabetes.

Clinical scenario: Adults with established type 1 diabetes and concurrent obesity (BMI ≥30.0 kg/m², or ≥27.5 kg/m² in Asian American individuals). Obesity management strategies from the general adult population are applied to this sub-population with appropriate clinical judgment for the complexities of type 1 diabetes.

Approach overview

For carefully selected patients, the protocol includes metabolic surgery as a highly individualized option — reached only after thorough multidisciplinary evaluation and extensive counseling. Selection criteria, the full evaluation pathway, and the complete decision algorithm are detailed in the structured protocol.

References

DOI: 10.2337/dc26-S008

Apply obesity management strategies used in the general adult population, including GLP-1 RA–based therapy and metabolic surgery, to adults with type 1 diabetes who have obesity (BMI ≥30.0 kg/m², or ≥27.5 kg/m² in Asian American individuals).
Metabolic surgery represents a highly individualized option for management of obesity in people with type 1 diabetes.
In conclusion, using a multidisciplinary approach a careful evaluation and extensive counseling is required to select people with type 1 diabetes who would benefit the most from metabolic surgery while individualizing goals and setting realistic expectations.

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Treatment of Obesity Due to Excess Calories in Adults with Type 1 Diabetes

Approach overview

References