8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: <i>Standards of Care in Diabetes—2023</i>

ElSayed, Nuha A.; Aroda, Vanita R.; Bannuru, Raveendhara R.; Brown, F. C.; Bruemmer, Dennis; Collins, Billy; Hilliard, Marisa E.; Isaacs, Diana; Johnson, Eric L.; Kahan, Scott; Khunti, Kamlesh; Lyons, Sarah K.; Perry, Mary Lou; Prahalad, Priya; Pratley, Richard E.; Seley, Jane Jeffrie; Stanton, Robert C.; Gabbay, Robert A.

doi:10.2337/dc23-s008

Cited by 139 publications

(156 citation statements)

References 131 publications

(101 reference statements)

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“… 25 Obesity was defined as BMI ≥30.0. 33 Analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC) and R-4.0.0 (R Foundation for Statistical Computing, Vienna, Austria).…”

Section: Methodsmentioning

confidence: 99%

Denosumab and incidence of type 2 diabetes among adults with osteoporosis: population based cohort study

Lyu

Zhao

Zhang

et al. 2023

BMJ

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Objective To estimate the effect of denosumab compared with oral bisphosphonates on reducing the risk of type 2 diabetes in adults with osteoporosis. Design Population based study involving emulation of a randomized target trial using electronic health records. Setting IQVIA Medical Research Data primary care database in the United Kingdom, 1995-2021. Participants Adults aged 45 years or older who used denosumab or an oral bisphosphonate for osteoporosis. Main outcome measures The primary outcome was incident type 2 diabetes, as defined by diagnostic codes. Cox proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals, comparing denosumab with oral bisphosphonates using an as treated approach. Results 4301 new users of denosumab were matched on propensity score to 21 038 users of an oral bisphosphonate and followed for a mean of 2.2 years. The incidence rate of type 2 diabetes in denosumab users was 5.7 (95% confidence interval 4.3 to 7.3) per 1000 person years and in oral bisphosphonate users was 8.3 (7.4 to 9.2) per 1000 person years. Initiation of denosumab was associated with a reduced risk of type 2 diabetes (hazard ratio 0.68, 95% confidence interval 0.52 to 0.89). Participants with prediabetes appeared to benefit more from denosumab compared with an oral bisphosphonate (hazard ratio 0.54, 0.35 to 0.82), as did those with a body mass index ≥30 (0.65, 0.40 to 1.06). Conclusions In this population based study, denosumab use was associated with a lower risk of incident type 2 diabetes compared with oral bisphosphonate use in adults with osteoporosis. This study provides evidence at a population level that denosumab may have added benefits for glucose metabolism compared with oral bisphosphonates.

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“… 25 Obesity was defined as BMI ≥30.0. 33 Analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC) and R-4.0.0 (R Foundation for Statistical Computing, Vienna, Austria).…”

Section: Methodsmentioning

confidence: 99%

Denosumab and incidence of type 2 diabetes among adults with osteoporosis: population based cohort study

Lyu

Zhao

Zhang

et al. 2023

BMJ

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“…2 Furthermore, patients who receive both metformin and SGLT2 inhibitors share the characteristic of being antidiabetic agents that are expected to result in weight loss. 28 In addition, SGLT2 inhibitors have a known risk of fractures in clinical trials and there are warnings about their use the cautions use in older adults with geriatric syndromes in Japan. 29 Hence, in addition to the fracture-protective effect of metformin, the relative risk of hip fracture may be reduced because metformin and SGLT2 inhibitors are prescribed to patients who are not frail.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, because metformin is often prescribed in the early stages of T2DM, the overall risk of fractures may be reduced in metformin users 2 . Furthermore, patients who receive both metformin and SGLT2 inhibitors share the characteristic of being antidiabetic agents that are expected to result in weight loss 28 . In addition, SGLT2 inhibitors have a known risk of fractures in clinical trials and there are warnings about their use the cautions use in older adults with geriatric syndromes in Japan 29…”

Section: Discussionmentioning

confidence: 99%

Impact of sodium‐glucose cotransporter‐2 inhibitors on the risk of hip fracture in older patients in Japan using a nationwide administrative claims database: A matched case–control study

Saito

Nojiri

Kasai

et al. 2023

Geriatrics Gerontology Int

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Aim Some clinical trials have shown that sodium‐glucose cotransporter‐2 (SGLT2) inhibitors are associated with fracture risk. However, this notion remains controversial. This study aimed to evaluate hip fracture risk after the use of SGLT2 inhibitors while controlling for factors that may affect fracture risk. Furthermore, hip fracture risk is evaluated in relation to the SGLT2 inhibitors component and its concomitant use with other antidiabetic agents. Methods Using large‐scale real‐world data, this case–control study investigated hospitalized patients between January 2018 and December 2020. Patients were aged 65–89 years and had been prescribed with SGLT2 inhibitors at least twice. Patients with hip fracture (cases) and those without (controls) were identified via 1:3 matching according to sex, age (±3 years), hospital size classification, and number of concomitant antidiabetic agents. Exposure to SGLT2 inhibitors of the cases and controls was compared with the use of multivariate conditional logistic regression. Results After matching, 396 cases and 1081 controls were identified. The adjusted odds ratio for patients receiving treatment with SGLT2 inhibitors was 0.83 (95% confidence interval: 0.55–1.26), indicating no increase in hip fracture risk. Additionally, no increased risk was observed with respect to SGLT2 inhibitors by component or concomitant use with other antidiabetic agents. Conclusion Our study showed that SGLT2 inhibitors do not increase hip fractures in older patients. However, because the risk assessment of SGLT2 inhibitors by component and their concomitant use with other antidiabetic agents is based on a limited number of patients, it is important to interpret the results with caution. Geriatr Gerontol Int 2023; 23: 418–425.

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“…Strong research suggests that obesity management can delay the progression of prediabetes to type 2 diabetes and facilitate the treatment of type 2 diabetes [ 13 – 15 ]. In addition, the American Diabetes Association (ADA) also recommends weight loss based on intensive lifestyle interventions to achieve optimal control of traditional cardiovascular risk factors in overweight or obese adults with type 2 diabetes [ 16 ]. According to the SURPASS program's findings, tirzepatide significantly reduced body weight in type 2 diabetics when compared to baseline, and all dosages of tirzepatide caused greater weight loss when compared to GLP-1RAs [ 8 , 10 ].…”

Section: Tirzepatidementioning

confidence: 99%

Research Progress on the GIP/GLP-1 Receptor Coagonist Tirzepatide, a Rising Star in Type 2 Diabetes

Jin

Yue

et al. 2023

Journal of Diabetes Research

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Type 2 diabetes mellitus (T2DM) is a chronic progressive metabolic disease that has become a growing health problem worldwide, and the dangers of hyperglycemia and its chronic complications have long been considered a goal of diabetes treatment. In recent years, tirzepatide has become the first dual GIP/GLP-1R agonist approved for the treatment of diabetes mellitus in the United States as a new hypoglycemic medicine. Its hypoglycaemic and weight loss effects have been demonstrated in several large clinical trials, and there is also evidence that it has great potential for cardiovascular protection. In addition, the very concept of synthetic peptides opens up many unknown possibilities for tirzepatide. Ongoing trials (NCT04166773) and evidence suggest that it appears to be a promising drug in the areas of NAFLD, renal, and neuroprotection. Based on preclinical studies and clinical trials, the aim of this article is to discuss the latest clinical developments in tirzepatide, to focus on its differences with other incretin therapies, and to suggest future possibilities and mechanisms of tirzepatide therapy.

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8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: Standards of Care in Diabetes—2023

Cited by 139 publications

References 131 publications

Denosumab and incidence of type 2 diabetes among adults with osteoporosis: population based cohort study

Denosumab and incidence of type 2 diabetes among adults with osteoporosis: population based cohort study

Impact of sodium‐glucose cotransporter‐2 inhibitors on the risk of hip fracture in older patients in Japan using a nationwide administrative claims database: A matched case–control study

Research Progress on the GIP/GLP-1 Receptor Coagonist Tirzepatide, a Rising Star in Type 2 Diabetes

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