Immune cell–adipose tissue crosstalk in metabolic diseases with a focus on type 1 diabetes – published online 04/06/2025

Adipose tissue, once considered a passive energy depot, is now recognised as an immunologically rich and reactive organ, with implications for the pathophysiology and management of type 1 diabetes. In addition, the dramatic rise in global obesity rates has introduced unique challenges for the understanding and management of type 1 diabetes, traditionally viewed as a disease affecting lean individuals. In this issue, Alzaid et al (https://doi.org/10.1007/s00125-025-06437-z) highlight how obesity-induced chronic inflammation (meta-inflammation) in adipose tissue disrupts immune regulation, potentially promoting autoimmune responses against pancreatic beta cells. The authors discuss the epidemiological evidence linking obesity to increased type 1 diabetes susceptibility, detail mechanisms underlying immune cell–adipose interactions, and explore how emerging technologies and precision medicine approaches are reshaping diabetes care. The authors conclude that addressing interactions between obesity and type 1 diabetes is required to improve clinical outcomes, reduce complications and develop targeted therapies tailored to this dual metabolic–immune challenge. The figures from this review are available as a downloadable slideset.

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