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Diabetologia. 2013 Jul;56(7):1462-70. doi: 10.1007/s00125-013-2904-2. Epub 2013 Apr 24.

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

Author information

1
Department of Medicine, Royal Hampshire County Hospital, Romsey Road, Winchester, SO22 5DG, UK. Steve.Cleland@hhft.nhs.uk

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.

PMID:
23613085
PMCID:
PMC3671104
DOI:
10.1007/s00125-013-2904-2
[Indexed for MEDLINE]
Free PMC Article

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