Insulin resistance in type 1 diabetes: what is 'double diabetes' and what are the risks?

S. J. Cleland, B. M. Fisher, H. M. Colhoun, N. Sattar, J. R. Petrie

    Research output: Contribution to journalReview articlepeer-review

    116 Citations (Scopus)

    Abstract

    In this review, we explore the concept of 'double diabetes', a combination of type 1 diabetes with features of insulin resistance and type 2 diabetes. After considering whether double diabetes is a useful concept, we discuss potential mechanisms of increased insulin resistance in type 1 diabetes before examining the extent to which double diabetes might increase the risk of cardiovascular disease (CVD). We then go on to consider the proposal that weight gain from intensive insulin regimens may be associated with increased CV risk factors in some patients with type 1 diabetes, and explore the complex relationships between weight gain, insulin resistance, glycaemic control and CV outcome. Important comparisons and contrasts between type 1 diabetes and type 2 diabetes are highlighted in terms of hepatic fat, fat partitioning and lipid profile, and how these may differ between type 1 diabetic patients with and without double diabetes. In so doing, we hope this work will stimulate much-needed research in this area and an improvement in clinical practice.

    Original languageEnglish
    Pages (from-to)1462-1470
    Number of pages9
    JournalDiabetologia
    Volume56
    Issue number7
    DOIs
    Publication statusPublished - 2013

    Keywords

    • Obesity
    • Double diabetes
    • WEIGHT-GAIN
    • INTRAPERITONEAL INSULIN
    • HDL-cholesterol
    • Type 2 diabetes
    • PITTSBURGH EPIDEMIOLOGY
    • Review
    • CARDIOVASCULAR-DISEASE
    • LIPOPROTEIN COMPOSITION
    • Insulin resistance
    • Cardiovascular disease
    • METABOLIC SYNDROME
    • Type 1 diabetes
    • Hepatic fat
    • SERUM-LIPIDS
    • Metabolic syndrome
    • CORONARY-ARTERY-DISEASE
    • COMPLICATIONS TRIAL
    • HEPATIC LIPASE ACTIVITY

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