Obesity and Type 2 Diabetes: Two Diseases with a Need for Combined Treatment Strategies - EASO Can Lead the Way

Abstract

Obesity is a chronic metabolic disease affecting adults and children worldwide. It has become one of the leading causes of death, as obesity is known to be the main risk factor for a number of non-communicable diseases, in particular type 2 diabetes. This close relationship led to the connotation 'diabesity', highlighting the fact that the majority of individuals with diabetes are overweight or obese. Until today the BMI is still used to classify overweight and obesity. Since reduced muscle mass is highly prevalent throughout the BMI range, the measurement of body composition is strongly recommended. Moreover, it is essential for monitoring the course of weight reduction, which is part of every effective anti-obesity treatment. Weight reduction can be achieved via different weight loss strategies, including lifestyle intervention (diet and exercise), pharmacotherapy, or bariatric surgery. However, not all of these strategies are suitable for all patients, and any further needs should be considered. Besides, attention should also be drawn to concomitant therapies. These therapies may promote additional weight gain and further trigger the deterioration of blood glucose control. Thus, therapeutic strategies are warranted, which can be easily used for the management of obese patients with type 2 diabetes to achieve their glycemic and weight loss goals.

European Society of Endocrinology Clinical Practice Guideline: Endocrine work-up in obesity

“…Beside general drugs used to manage obesity complications, several dietary supplements are commonly taken by patients with obesity, with the aim of facilitating weight loss or well-being, controlling glucose metabolism or preventing cardiovascular events. Some of these exogenous substances may interfere with the regulation of various hormonal axes as well as with hormonal assays (2,18,19).…”

“…Obesity is an emerging condition and plays a central role in the development of non-communicable diseases like diabetes, hyperlipidaemia, hypertension, cardiovascular disease and cancer (1). Due to the tight relation with type 2 diabetes, the combination of the two diseases is often called 'diabesity' and treated accordingly (2). Following, it is important for obesity to become an integral part of medicine, and multidisciplinary European guidelines have been released (3).…”

„Diabesity“ – Adipositas und Typ-2-Diabetes (Update 2019)

“…Zu diesen sind u. a. auch viele traditionelle Antidiabetika zu rechnen. Im Allgemeinen sind heute jene antidiabetischen Therapien zu bevorzugen, die das Gewicht der Diabetiker nicht steigern, sondern -wenn möglich -eine Gewichtsreduktion unterstützen (Metformin, DPP-IV-Inhibitoren, SGLT-Inhibitoren und GLP1-Analoga) [44].…”

“…Hierzu zählen u. a. viele Psychopharmaka, welche zugleich auch die wichtigste gewichtssteigernde Begleittherapie per se darstellen. Des Weiteren sind auch Steroidhormone oder Betablocker für eine moderate Gewichtssteigerung bekannt [44]. Unter Letzteren ist zudem eine gehäufte Diabetesmanifestation zu beobachten [45].…”

Effect of a 12‐week endurance training program on force transfer and membrane integrity proteins in lean, obese, and type 2 diabetic subjects

“…It is caused by an energy imbalance between calories consumed and calories expended, mainly as a result of increased intake of energy‐dense foods and decreased physical activity. Obesity is linked to many physiological conditions, of which type 2 diabetes is one of the most common (Eckel et al., 2011; Leitner et al., 2017). Obesity and type 2 diabetes have been suggested to accelerate the loss of muscle strength with age (Park et al., 2006) and muscle strength has been acknowledged as the critical factor for determining physical disability and mortality (Manini & Clark, 2012).…”