Revisiting weight reduction and management in the diabetic patient: Novel therapies provide new strategies

Abstract

Weight gain has been so synonymous with diabetes care that overweight/obesity is considered an intractable aspect of diabetes and its management. A healthy body mass index (BMI) is paramount, however, in preserving the cardiometabolic profile, slowing the course of the disease and extending the life expectancy of patients. It is also key to fostering a healthy and productive society at large. Two trends in care press us to challenge our assumptions about weight control in this population by reconsidering traditional approaches to the management of diabetes. First, new anti-diabetes drug classes have emerged that are more “weight-friendly” than previously available treatments and “gentler” on the faltering β cell. Second, novel anti-obesity agents are proving efficacious in patients with diabetes. This paper presents the composite of newer and older anti-obesity and anti-diabetic drugs. It makes recommendations for anti-diabetic regimens and processes of care that engender weight loss, or neutralize or minimize weight gain, while getting many patients to their glycated hemoglobin (HbA1c) goal. Anti-obesity agents that can be safely and effectively incorporated into these regimens for the patient needing supplemental support are reviewed in detail

Keywords:

• Diabetes
• overweight
• obesity
• pharmacologic
• treatment

Declaration of interest

Editorial support was provided by Imprint Publication Science, New York, NY, USA, with funding from Eisai Inc. Eisai Inc. was not involved in the content development of this paper. S Schwartz is an advisor for BI-Lilly, Takeda, Salix, Merck and AstraZeneca-BMS, and on the Speaker’s Bureau for BI-Lilly, Novo Nordisk, Merck, Salix and Takeda. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

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