Traitements de l’obésité en cas de diabète de type 1 : bénéfices et coût

Loumaye, Audrey
(2026) Louvain médical — Vol. 145, n° 3, p. 23-27 (2026)

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(en) [Obesity treatments in case of type 1 diabetes: benefits and costs] Obesity has become an increasingly common comorbidity among people living with type 1 diabetes (T1D), with prevalence rates now similar to those observed in the general population. It results from several complex mechanisms involving insulin therapy-related factors, behavioral aspects, and an obesogenic environment. In T1D patients, obesity contributes to increased insulin resistance, poorer glycemic control, and a higher risk of cardiometabolic and microvascular complications. The management of obesity in T1D primarily relies on a multidisciplinary approach combining dietary interventions, physical activity, and psychological support, with careful adjustment of insulin therapy to minimize the risk of hypoglycemia. When lifestyle interventions are insufficient, emerging evidence suggests that GLP-1 receptor agonists and dual GLP-1/GIP receptor agonists may represent therapeutic options in selected patients. Recent studies indicate that semaglutide and tirzepatide induce clinically meaningful weight loss, along with improvements in glycemic control, increased time in range, and, in some cases, reduced insulin requirements, without a significant increase in hypoglycemia or diabetic ketoacidosis. However, most of the available evidence is based on small, short-term studies that were often conducted in highly optimized technological settings. Larger and longer randomized controlled trials are required to better define the safety, efficacy, cost, and appropriate role of these agents in the management of obesity associated with T1D.
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Loumaye, A. (2026). Traitements de l’obésité en cas de diabète de type 1 : bénéfices et coût. Louvain médical, 145(3), 23-27. https://hdl.handle.net/2078.5/276569 (Original work published 2026)