Management of diabetes across the course of disease: minimizing obesity-associated complications

Caroline M ApovianMedicine and Pediatrics, Boston University School of Medicine; Nutrition and Weight Management Center; and Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston Medical Center, Boston, MA, USAAbstract: Obesity increases the risk for developing type 2 diab...

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Autor principal:	Apovian CM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/e464b356122947bcac2cf3810a7238f8
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spelling	oai:doaj.org-article:e464b356122947bcac2cf3810a7238f82021-12-02T04:02:51ZManagement of diabetes across the course of disease: minimizing obesity-associated complications1178-7007https://doaj.org/article/e464b356122947bcac2cf3810a7238f82011-10-01T00:00:00Zhttp://www.dovepress.com/management-of-diabetes-across-the-course-of-disease-minimizing-obesity-a8457https://doaj.org/toc/1178-7007Caroline M ApovianMedicine and Pediatrics, Boston University School of Medicine; Nutrition and Weight Management Center; and Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston Medical Center, Boston, MA, USAAbstract: Obesity increases the risk for developing type 2 diabetes mellitus (T2DM) and this in turn correlates with an elevated probability of long-term diabetes complications once diabetes is established. Interventions aimed at lowering weight via changes in diet and lifestyle have repeatedly been shown to improve glycemic control in patients with T2DM and even to reverse early disease. Weight gain, a potential side effect of treatment for patients with T2DM, is also an important concern, and it has been noted that weight increases associated with antidiabetes therapy may blunt cardiovascular risk reductions achieved by decreasing blood glucose. Among older agents, metformin and acarbose have the lowest risk for weight gain, while sulfonylureas, meglitinides, and thiazolidinediones are all associated with weight increases. Clinical trial results have also consistently demonstrated that treatment with glucagon-like peptide-1 receptor agonists and amylin lowers weight, and that dipeptidyl peptidase-4 inhibitors are weight neutral in patients with T2DM. Conventional human insulin formulations are known to increase weight in patients with T2DM. However, some insulin analogs, particularly insulin detemir, have lower liability for this adverse event. The use of both pharmacologic and surgical therapies aimed at treating obesity rather than lowering blood glucose have the potential to improve glycemic control and even resolve T2DM in some patients.Keywords: bariatric, diabetes, incretin, insulin, obesity, oral antidiabetes agentsApovian CMDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2011, Iss default, Pp 353-369 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Apovian CM Management of diabetes across the course of disease: minimizing obesity-associated complications
description	Caroline M ApovianMedicine and Pediatrics, Boston University School of Medicine; Nutrition and Weight Management Center; and Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston Medical Center, Boston, MA, USAAbstract: Obesity increases the risk for developing type 2 diabetes mellitus (T2DM) and this in turn correlates with an elevated probability of long-term diabetes complications once diabetes is established. Interventions aimed at lowering weight via changes in diet and lifestyle have repeatedly been shown to improve glycemic control in patients with T2DM and even to reverse early disease. Weight gain, a potential side effect of treatment for patients with T2DM, is also an important concern, and it has been noted that weight increases associated with antidiabetes therapy may blunt cardiovascular risk reductions achieved by decreasing blood glucose. Among older agents, metformin and acarbose have the lowest risk for weight gain, while sulfonylureas, meglitinides, and thiazolidinediones are all associated with weight increases. Clinical trial results have also consistently demonstrated that treatment with glucagon-like peptide-1 receptor agonists and amylin lowers weight, and that dipeptidyl peptidase-4 inhibitors are weight neutral in patients with T2DM. Conventional human insulin formulations are known to increase weight in patients with T2DM. However, some insulin analogs, particularly insulin detemir, have lower liability for this adverse event. The use of both pharmacologic and surgical therapies aimed at treating obesity rather than lowering blood glucose have the potential to improve glycemic control and even resolve T2DM in some patients.Keywords: bariatric, diabetes, incretin, insulin, obesity, oral antidiabetes agents
format	article
author	Apovian CM
author_facet	Apovian CM
author_sort	Apovian CM
title	Management of diabetes across the course of disease: minimizing obesity-associated complications
title_short	Management of diabetes across the course of disease: minimizing obesity-associated complications
title_full	Management of diabetes across the course of disease: minimizing obesity-associated complications
title_fullStr	Management of diabetes across the course of disease: minimizing obesity-associated complications
title_full_unstemmed	Management of diabetes across the course of disease: minimizing obesity-associated complications
title_sort	management of diabetes across the course of disease: minimizing obesity-associated complications
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/e464b356122947bcac2cf3810a7238f8
work_keys_str_mv	AT apoviancm managementofdiabetesacrossthecourseofdiseaseminimizingobesityassociatedcomplications
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Management of diabetes across the course of disease: minimizing obesity-associated complications

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