As a response to several various factors, some individuals with type 1 diabetes may develop characteristics of type 2 diabetes. Discover what may put you in danger and the way you may try to forestall and manage ‘double diabetes.’

While people are usually not diagnosed with each type 1 and sort 2 diabetes at the identical time, those with type 1 could also be in danger for also developing characteristics of type 2 diabetes over time.

Type 1 diabetes is an autoimmune condition through which the body not produces insulin. With type 2 diabetes, the body can still produce some, but not enough, insulin, and the body cannot use the insulin it makes efficiently. This results in chronic high blood glucose levels. ‘Insulin resistance’ is the term used to explain when the body becomes less and fewer efficient at using insulin.

While the 2 conditions are fundamentally different, individuals with type 1 can still develop the lack to make use of prescribed insulin efficiently, mirroring among the symptoms seen in those with type 2. This often happens due to a condition called metabolic syndrome. The term ‘metabolic syndrome’ refers to a gaggle of conditions that usually occur together, including:

• Hypertension
• Extra weight or obesity (specifically excess fat across the waist)
• High blood glucose
• Abnormal levels of cholesterol
• High fat levels within the blood

Individuals who have a mix of some or all of those conditions are said to have metabolic syndrome. Having metabolic syndrome increases an individual’s risk for heart disease and sort 2 diabetes. Studies suggest that a majority of individuals with type 2 diabetes have metabolic syndrome. And while metabolic syndrome increases the chance of type 2 diabetes, individuals with type 1 can still have it, which might result in insulin resistance and other characteristics of type 2.

This phenomenon is usually known as “double diabetes,” though some experts have suggested a more accurate phrase can be “individuals with type 1 diabetes who even have type 2 characteristics.”

“Those of us in the sphere want people to know that even when you might have type 1, you may develop metabolic syndrome, so it’s essential to be assessed for cardiovascular risk,” said Dr. Anne Peters, an endocrinologist and professor of clinical medicine on the University of Southern California, Keck School of Medicine. “[Double diabetes] is a shorthand for clinicians, but the bottom line is that it shows up as individuals with type 1 who’ve metabolic syndrome.” Peters clarified that while she looks to scale back cardiovascular risk in everyone, treatment is particularly vital for individuals with metabolic syndrome.

How prevalent is ‘double diabetes?’

In a recent study geared toward exploring the prevalence of diabetes, out of 107 participants with type 1 diabetes, 57 of them may very well be classified as having extra weight or obesity based on their BMI, and 62 of them met the definition of getting “double diabetes.” Those that had “double diabetes” were more prone to be older, have had diabetes for an extended time, have a better A1C, and have abnormal lipids.

Which risk aspects can result in ‘double diabetes?’

The aspects that place individuals with type 1 at a better risk for developing double diabetes are in some ways much like the chance aspects for developing type 2 alone. In keeping with this study in individuals with type 1, extra weight or obesity, a sedentary lifestyle, intensive insulin therapy, and being in a high-risk ethnic group may all contribute to the chance for double diabetes.

“Essentially the most common feature of metabolic syndrome is extra weight, and two thirds of individuals with type 1 are either obese or obese,” added Peters. “By the point they reach a certain age of their 60s, about two thirds will even have [high blood pressure]. Also, simply because you might have type 1 doesn’t mean you don’t have type 2 genes,” she said, explaining that those with type 1 who’ve a family history of type 2 are also at a better risk level.

Contributing to those risk aspects is the concerning incontrovertible fact that the variety of individuals with type 1 diabetes and extra weight or obesity is increasing. In one study, which monitored a big group of individuals with type 1 diabetes over a period of 20 years, the number of people that had extra weight increased by nearly 50%, while the variety of individuals with obesity increased seven-fold.

Researchers have established that insulin therapy may cause weight gain. This could create a vicious cycle where insulin therapy results in weight gain, which each contribute to insulin resistance, which might lead back to a rise in insulin dosing. Actually, considered one of the signs of double diabetes in individuals with type 1 would be the need for increasingly insulin to satisfy glucose targets. For this reason early on, weight management, together with glucose management, are crucial for individuals with type 1 to forestall insulin resistance.

What are you able to do to forestall or manage ‘double diabetes?’

There are methods to reduce the chance of developing double diabetes.

Lifestyle changes similar to improving your weight loss plan and getting loads of exercise can enable you to manage your weight and will help make the insulin you’re taking work more efficiently.

As a general guideline, the American Diabetes Association recommends getting half-hour of aerobic exercise on most days of the week. Aerobic exercises include activities like walking, running, cycling, or swimming. Moreover, eating foods which might be low-carb or high in nutrients like fiber and healthy fats can enable you to manage your weight and reduce insulin resistance.

As well as, your healthcare provider may think about using medications which might be only indicated for individuals with type 2 diabetes, similar to metformin, GLP-1 receptor agonists, or SGLT-2 inhibitors.

“I mainly give attention to weight reduction, so I exploit GLP-1s, but I also prescribe metformin,” said Peters. “I give attention to weight and exercise to bring down insulin resistance because a lot of these people have a much higher insulin resistance than others with type 1. I’m also more prone to start a statin [a cholesterol-lowering medication] at a younger age.”

While metformin will help decrease insulin resistance directly, GLP-1 receptor agonists and SGLT-2 inhibitors may help lower glucose levels and protect against complications like heart and kidney disease. GLP-1 receptor agonists may also be used for weight management and for treating obesity. These drugs are usually not indicated for individuals with type 1 diabetes, nevertheless, so talk along with your healthcare team to see if these options are protected and available to you. For example, taking SGLT-2 inhibitors has been shown to extend the chance of diabetic ketoacidosis (DKA) if you might have type 1.

In keeping with Peters, double diabetes comes right down to three key aspects: weight, lipids, and blood pressure. “I aim to treat each of those aspects, bring down insulin resistance as much as possible, and proceed to treat the kind 1 diabetes, because that’s still there,” she said.

Take into account that insulin resistance, together with extra weight and obesity, is just not specific to those with type 2 diabetes. Understanding how these items can affect your health is significant for managing your glucose levels and stopping complications.

“I’ve at all times been a believer that anybody, with or without diabetes, with or without metabolic syndrome, needs to take care of their weight and exercise,” said Peters. “Maintaining insulin sensitivity, to me, is an indication of health regardless of who you might be. All of us are at a better risk for these health issues as we become older, so keep fit!”

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