Medical Management of Diabesity: Do We Have Realistic Targets?

  title={Medical Management of Diabesity: Do We Have Realistic Targets?},
  author={Joseph M Pappachan and Ananth K Viswanath},
  journal={Current Diabetes Reports},
Purpose of ReviewThe global prevalence of “diabesity”—diabetes related to obesity—is increasing steadily over the past few decades because of the obesity epidemic. Although bariatric surgery is an effective treatment option for patients with diabesity, its limited availability, invasiveness, relatively high costs and the potential for surgical and postsurgical complications restrict its widespread use. Therefore, medical management is the only option for a majority of patients with diabesity… 

Diabesity and antidiabetic drugs.

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This review summarises the current evidence base for the non-pharmacological interventions in the management of diabetes and finds them useful for the effective management of even type 1 diabetes mellitus when used along with insulin therapy especially in those with obesity.

Updates on obesity pharmacotherapy

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Bariatric Surgery in the Treatment of Type 2 Diabetes

The impact of bariatric surgery on diabetes mellitus is characterized by recalling its history, examining the clinical data, exploring the putative mechanisms of action, and anticipating its future.

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The present work aims to collect the different changes reported in gut microbiota in patients with T2DM associated with obesity and their possible role in the onset, development, and establishment of the disease.

Antiobesity drugs in the management of type 2 diabetes: A shift in thinking?

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Diabetes, Vascular Aging and Stroke: Old Dogs, New Tricks?

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A consensus of expert endocrinologists representing South Asian countries including India, Pakistan, Bangladesh, Nepal, Sri Lanka, Afghanistan and the Maldives on essential recommendations related to the use of GLP-1 RAs in a real-world scenario is presented.

Impact of Weight Change in Adults with Type 2 Diabetes Mellitus: A Literature Review and Critical Analysis

Studies regarding weight change in T2DM patients demonstrated varying effects on glycemic control and a positive association with costs and resource use, where weight loss was associated with decreased costs and resources use.



Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline From the American College of Physicians

This guideline recommends that clinicians add oral pharmacologic therapy in patients diagnosed with type 2 diabetes when lifestyle modifications have failed to adequately improve hyperglycemia and grades the evidence and recommendations by using the American College of Physicians clinical practice guidelines grading system.

Combination therapy with GLP-1 analogues and SGLT-2 inhibitors in the management of diabesity: the real world experience

The results suggest that combination therapy with GLP-1 agonists and SGLT-2 inhibitors is a promising option for patients with diabesity.

Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes.

Among obese patients with uncontrolled type 2 diabetes, 3 years of intensive medical therapy plus bariatric surgery resulted in glycemic control in significantly more patients than did medical therapy alone.

Effect of orlistat on glycaemic control in overweight and obese patients with type 2 diabetes mellitus: a systematic review and meta‐analysis of randomized controlled trials

Treatment with orlistat plus lifestyle intervention resulted in significantly greater weight loss and improved glycaemic control in overweight and obese patients with type 2 diabetes compared with lifestyle intervention alone.

Metformin and body weight

  • A. Golay
  • Medicine, Biology
    International Journal of Obesity
  • 2008
The weight-neutral or weight-sparing effects of metformin constitute a therapeutic advantage in diabetes management where other first-line oral antidiabetic treatments often promote clinically significant weight gain.

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The landmark ORIGIN trial provides many lessons relating to the concept and application of early insulin therapy for the prevention and safe and effective induction and maintenance of glycemic control in type 2 diabetes.

A Multicenter Observational Study of Incretin-based Drugs and Heart Failure.

In this analysis of data from large cohorts of patients with diabetes, incretin-based drugs were not associated with an increased risk of hospitalization for heart failure, as compared with commonly used combinations of oral antidiabetic drugs.

Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes.

Patients with type 2 diabetes at high risk for cardiovascular events who received empagliflozin, as compared with placebo, had a lower rate of the primary composite cardiovascular outcome and of death from any cause when the study drug was added to standard care.