Beyond BMI in Type 1 Diabetes: Body Composition and Clinical Outcomes

Type 1 diabetes (T1D) has traditionally been associated with a lean phenotype; however, increasing rates of overweight and obesity are reshaping its clinical presentation. Emerging evidence suggests that altered body composition - including visceral adiposity, ectopic fat accumulation, and reduced muscle mass-may significantly influence insulin resistance, cardiovascular risk, and long-term outcomes in T1D. Despite this, clinical assessment in routine practice still relies predominantly on BMI.While individual articles addressing obesity, insulin resistance, or physical activity in T1D have been published in Frontiers journals, there has been no dedicated Research Topic specifically focused on body composition in T1D. Existing collections explore broader themes such as metabolic complexity or lifestyle interventions but do not centrally address altered body composition—including visceral adiposity, sarcopenia, ectopic fat deposition, and their clinical implications—as a unifying and clinically actionable concept.Given the rising prevalence of overweight and obesity in T1D, the emergence of “double diabetes” phenotypes, and the impact of modern insulin delivery systems and adjunctive therapies on weight and body composition, a focused Research Topic is both timely and necessary. This collection would uniquely integrate risk stratification, cardiometabolic outcomes, and practical clinical assessment beyond BMI in T1D, addressing a clear gap within existing Frontiers Research Topics.This Research Topic aims to examine the clinical relevance of body composition assessment in T1D and its implications for risk stratification, therapeutic decision-making, and long-term outcomes. We seek to explore whether measures beyond BMI can better identify high-risk phenotypes and guide personalized management strategies.Suitable themes for manuscripts include, but are not limited to:• Visceral adiposity and cardiovascular risk in T1D• Sarcopenia and sarcopenic obesity in T1D• Insulin resistance and “double diabetes” phenotypes• Impact of automated insulin delivery systems on body composition• Effects of adjunctive therapies (e.g., GLP-1RA, SGLT2i) on body composition• Exercise interventions and muscle mass in T1D• DXA, MRI, BIA – clinical utility and feasibility• Ectopic fat and metabolic risk in T1D• Longitudinal changes in body composition and outcomes Topic editors: Anna Duda-Sobczak, Jennifer Snaith Source: https://www.frontiersin.org/research-topics/83302/beyond-bmi-in-type-1-diabetes-body-composition-and-clinical-outcomes