Incretin-Based Adjunct to Background Insulin Treatment for Managing Body Weight Excess in Type 1 Diabetes: An Expert Opinion Viewpoint From the Italian Association of Clinical Endocrinologists

Abstract

Overweight and obesity represent common chronic metabolic disorders in the general population, and observed trends describe a substantial growth in the prevalence of weight excess also among individuals with type 1 diabetes (T1D), the so-called ‘lean phenotype’ of diabetes. The sharp rise of weight excess and obesity-related cardio-nephron-metabolic burdens observed in T2D is expected to produce similar consequences in T1D, leading to the urgent need to endorse therapeutic protocols as in most parts of the World no adjunctive treatments are approved for T1D, making weight excess management challenging in these individuals. The notable results shown by newer glucagon-like peptide 1 receptor agonists (GLP-1RAs) and emerging dual agonists, especially while managing cardio-metabolic burdens, in T2D have encouraged fervent anecdotal and non-anecdotal research also in T1D, indicating that non-insulin injective agents can be effective and safe. With this expert opinion paper, the members of four of the most representative Committees of the Italian Association of Clinical Endocrinologists provide the scientific community with a state-of-the-art report on the use of GLP-1RAs and other incretin-based injective therapy to treat body weight excess in T1D individuals and new insights on the topic with reliable methodology and clinical expertise.