Beyond Glycemia in T1D

Pinzon Cortes J.A.; Narongkiatikhun P.; Fuhri Snethlage C.M.; Del Castillo D.; Tommerdahl K.L.; Nadeau K.J.; Bjornstad P. · Endocrinology and Metabolism Clinics of North America (2026) · DOI: 10.1016/j.ecl.2026.04.008

Resumen

Insulin resistance (IR) is an underrecognized feature of type 1 diabetes (T1D), present even in lean individuals. Rising obesity rates have further amplified this burden, creating a mixed metabolic phenotype that accelerates cardiorenal disease. Paradoxically, despite fewer traditional cardiovascular risk factors, individuals with T1D experience higher rates of cardiorenal complications than those with type 2 diabetes, a gap not fully explained by glycemic control. This article examines the epidemiologic, pathophysiologic, and mechanistic underpinnings of this hidden cardiorenal risk, including key drivers of end-organ damage. Broader therapeutic interventions targeting IR in T1D are essential to prevent future cardiorenal disease.

Instituciones: Universidad Científica del Sur