Washington [US]Oct. 1 (ANI): A new study found that weight loss of 15 percent or more should become a key focus in treating type 2 diabetes (T2D) as it has the potential to advance slow down and even reverse many cases and reduce complications.
The results of the study were published in the journal “The Lancet”.
The proposed strategy was presented at this week’s annual meeting of the European Association for the Study of Diabetes (EASD), which was held online this year.
“We suggest that for most patients with type 2 diabetes without cardiovascular disease, the primary focus of treatment should be treating the underlying abnormality and cause of the disease: obesity,” stated Dr, Dallas, Texas , UNITED STATES.
“Such an approach would have the added benefit of addressing not only high blood sugar but other obesity-related complications such as fatty liver, obstructive sleep apnea, osteoarthritis, high blood pressure and an elevated blood lipid profile, and therefore a much greater impact on the person’s overall health than just controlling blood sugar alone, “added Dr. Lingvay added.
“Treating obesity to achieve permanent loss of 15 percent of body weight has been shown to have a major impact on the progression of type 2 diabetes and even lead to diabetes remission in some patients,” added co-author Dr . Priya Sumithran, University of Melbourne, added, Melbourne, VIC, Australia.
The evidence of the weight loss benefits in T2D management comes from several sources. In the DiRECT study, which looked at intensive lifestyle intervention in overweight or obese patients and a T2D duration of less than 6 years, 70 percent of patients had lost 15 kg or more (with an average starting weight of 100 kg ).
Studies of bariatric (bariatric) surgery have also shown both immediate and sustained benefits for patients with T2D and obesity – reducing the need for blood sugar lowering drugs within days of surgery and improving several health indicators over the long term.
The paper also discusses the various drug treatments that are available for weight management. Five active ingredients (orlistat, phentermine topiramate, naltrexone bupropion, liraglutide 30 mg and semaglutide 24 mg) have been approved for chronic weight management by one or more regulatory agencies worldwide.
Semaglutide Weekly 24 mg was approved by the U.S. Food and Drug Administration in June 2021. Many other drugs are also being developed, such as: and gastric inhibitory polypeptide (GIP)).
Studies of these new drugs, such as Semaglutide 24 mg and Tirzepatid 150 mg, have found that more than 25 percent of participants with T2D can easily lose 15 percent of their body weight, and most participants have blood sugar control nearing normal.
Most patients (40-70 percent) with type 2 diabetes have one or more characteristics of insulin resistance, which means that their T2D is likely driven by an increase in body fat.
“Key traits that identify people in whom an increase in body fat is a significant mechanistic contributor to type 2 diabetes are the presence of central obesity (fat around the waist), increased waist size, multiple skin spots, high blood pressure and fatty liver.” Explained Dr. Lingvay.
“In this population, we propose total weight loss of at least 15 percent as a treatment goal, with the intention of not only improving blood sugar control, but rather the most effective way of disrupting the basic pathophysiology of type 2 diabetes and thus its long-term course change and prevent the associated metabolic complications, “continues Dr. Lingvay.
The authors outlined important considerations in redefining treatment goals for patients with T2D to focus on sustainable weight loss. First, the initiative should be driven by updating treatment guidelines to include significant, sustained weight loss as the primary treatment goal for patients with T2D.
Health systems should focus on the upstream benefits of reducing obesity in preventing or controlling T2D, rather than the higher costs of treating people with progressive T2D and the range of complications that can accompany the disease.
“It is also important that management of the medical office realigns to effectively integrate weight management for patients with type 2 diabetes,” said Dr. Lingvay.
“Health professionals, especially those who routinely treat people with diabetes, should be trained and experienced in all aspects of obesity management. Support staff should be trained to assist patients on their weight loss journey, and practices should meet the need for specialized staff to deliver the educational component of the new proposed treatment strategies, “added Dr. Lingvay.
The authors concluded, “It is time to consider additional double-digit percentage weight loss as a primary goal for treating many patients with type 2 diabetes. This approach would address the pathophysiology of the disease. ”Process for Recognizing Type 2 Diabetes, Recognizing and metabolic the pathology of adipose tissue as a major cause of the continuum of obesity, type 2 diabetes and cardiovascular disease Achieving benefits that go well beyond glycemic control Disease with reversible complications and require postponement of clinical care. “(ANI)
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