In a nutshell
This article examined the evidence and made recommendations about weight loss in obese patients with type 2 diabetes (T2D).
Some background
Obesity is a common condition in people with T2D. Managing obesity in these patients can delay pre-diabetes advancing to T2D. Obesity management can also be helpful in treating T2D. Lifestyle changes to reduce weight include diet, exercise, and behavioral therapy. These are recommended for all patients. Patients with higher weight may also need drugs or surgery.
Methods & findings
In this article reviewed the current American Diabetes Association recommendations for the use of lifestyle changes, drugs, and surgery to reduce weight in patients with T2D.
It was recommended that overweight and obese patients with T2D begin a low-calorie diet and exercise program. Whatever diet used should result in 500-750 more calories being used every day than are being taken in. Such lifestyle changes can reduce blood glucose, triglycerides, blood pressure, and cholesterol levels. Benefits are seen with just 5% weight loss, though weight loss of 7% is ideal. When this weight loss is achieved, a weight maintenance program should be followed for at least a year.
Several drugs used to treat T2D can cause weight gain. When possible, physicians should choose medications that cause weight loss, or do not affect weight. In patients with higher weight there are several medications for weight loss available. These should be given in addition to a diet and exercise program. Treating obesity in this way is limited, and weight tends to be regained after the medication is stopped.
Several surgeries on the digestive system can improve control of blood glucose and cardiovascular health in obese patients with T2D. These surgeries can cause deficiencies of vitamins and minerals, and this must be monitored after surgery. People who have these surgeries should also be assessed for the need for mental health services to help with adjustment following surgery.
The bottom line
The article concluded that diet and exercise should be recommended for all patients with T2D who are overweight or obese. In some patients with a higher weight, drugs and/or surgery may also be suitable.
The fine print
The recommendations in this article are guides only, and should not replace a physician’s opinion.
What’s next?
Discuss the importance of obesity management with your physician.
Published By :
Diabetes Care
Date :
Dec 29, 2016
