Medical and surgical management of obesity and diabetes: what's new?

Abstract

We conducted a narrative review of the medical and surgical management of people with obesity and diabetes. Results of this review showed that a 5-10% loss in body weight can be achieved with a change in lifestyle, diet and behaviour and with approved pharmacological therapies in people with obesity and diabetes. New targeted therapies are now available for patients with previously untreatable genetic causes of obesity. Compared to medical treatment, metabolic and bariatric surgery is associated with significantly higher rates of remission from type 2 diabetes and lower rates of incident macrovascular and microvascular complications and mortality. The National Institute for Health and Care Excellence and the American Diabetes Association endorse metabolic and bariatric surgery in obese adults with type 2 diabetes and there may also be a role for this in obese individuals with type 1 diabetes. The paediatric committee of the American Society for Metabolic and Bariatric Surgery have recommended metabolic and bariatric surgery in obese adolescents with type 2 diabetes. Earlier and more aggressive treatment with metabolic and bariatric surgery in obese or overweight people with diabetes can improve morbidity and mortality.

Obesity: A critical risk factor in the COVID‐19 pandemic

“…The benefits of weight‐loss on complications of obesity, insulin resistance and systemic inflammation are well‐documented, especially after bariatric surgery 134‐136 . However, even short‐term small amounts of weight‐loss can show substantial metabolic benefits 137 .…”

“…Patients should be encouraged to make lifestyle changes focused on nutritional modification, calorie restriction and augmentation of exercise; individualized approaches are likely to yield most benefit. Bariatric surgery should be considered where clinically appropriate as it leads to improvements in obesity‐related metabolic comorbidities such as diabetes, hypertension, dyslipidaemia, insulin resistance and inflammation 136,138 . It slows the atherosclerotic process and reduces cardiovascular and all‐cause mortality.…”

The importance of facts and figures in diabetes care

“…This month, Professor Rayaz Malik, one of the journal’s associate editors, hosts the second overseas Diabetic Medicine symposium as part of the opening plenary session on 14 February 2020 at the fourth Qatar Diabetes, Endocrinology and Metabolic Conference. This event is marked by the publication of a review by the two speakers and colleagues . The article describes the importance of an earlier and more aggressive approach to weight management in order to slow the progressive global rise of type 2 diabetes.…”

Changes in the Proteome Profile of People Achieving Remission of Type 2 Diabetes after Bariatric Surgery

“…Bariatric surgery (BS) has been shown not only to be an effective therapy for weight loss, but also improves a variety of metabolic parameters conferring protection from cardiovascular (CVD) and other diseases [9,10]. Immediate post-operative weight-independent effects combined with weight loss can result in remission of T2DM in up to 80% of patients [10].…”