The challenge of managing coexistent type 2 diabetes and obesity

Bailey, Clifford J.

doi:10.1136/bmj.d1996

Cited by 25 publications

(12 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The drugs that may cause weight gain with their alternatives are mentioned in table 2 . Specifically in the management of diabetes, sulfonylureas, meglitines, thiazolidinediones and insulin induce weight gain, while acarbose ( ␣ -glucosidase inhibitor), metformin and gliptins (dipeptidyl peptidase-4 (DPP-4) inhibitors) are weight neutral ( table 3 ) [113,114] . Glucagon-like peptide-1 (GLP-1) receptor agonists decrease body weight by 2.9% (95% confidence interval 2.2-3.63) in a meta-analysis of 25 studies.…”

Section: Pharmacotherapymentioning

confidence: 99%

“…With the improvement in Table 3. Treatment for type 2 diabetes: mechanism of action and effects on glucose metabolism and body weight [113][114][115] intra-operative surgical management and optimisation of peri-operative care, many centres offer bariatric surgery to patients who exceed this age limit. Retrospective data of operations, mainly performed by laparoscopy in the last decade, are shown in table 4 [120][121][122][123][124][125][126] .…”

Section: Bariatric Surgerymentioning

confidence: 99%

See 1 more Smart Citation

Prevalence, Pathophysiology, Health Consequences and Treatment Options of Obesity in the Elderly: A Guideline

2012

View full text Add to dashboard Cite

The prevalence of obesity is rising progressively, even among older age groups. By the year 2030–2035 over 20% of the adult US population and over 25% of the Europeans will be aged 65 years and older. The predicted prevalence of obesity in Americans, 60 years and older was 37% in 2010. The predicted prevalence of obesity in Europe in 2015 varies between 20 and 30% dependent on the model used. This means 20.9 million obese 60+ people in the USA in 2010 and 32 million obese elders in 2015 in the EU. Although cut-off values of BMI, waist circumference and percentages of fat mass have not been defined for the elderly (nor for the elderly of different ethnicity), it is clear from several meta-analyses that mortality and morbidity associated with overweight and obesity only increases at a BMI above 30 kg/m<sup>2</sup>. Thus, treatment should only be offered to patients who are obese rather than overweight and who also have functional impairments, metabolic complications or obesity-related diseases, that can benefit from weight loss. The weight loss therapy should aim to minimize muscle and bone loss but also vigilance as regards the development of sarcopenic obesity – a combination of an unhealthy excess of body fat with a detrimental loss of muscle and fat-free mass including bone – is important in the elderly, who are vulnerable to this outcome. Life-style intervention should be the first step and consists of a diet with a 500 kcal (2.1 MJ) energy deficit and an adequate intake of protein of high biological quality together with calcium and vitamin D, behavioural therapy and multi-component exercise. Multi-component exercise includes flexibility training, balance training, aerobic exercise and resistance training. The adherence rate in most studies is around 75%. Knowledge of constraints and modulators of physical inactivity should be of help to engage the elderly in physical activity. The role of pharmacotherapy and bariatric surgery in the elderly is largely unknown as in most studies people aged 65 years and older have been excluded.

show abstract

Section: Pharmacotherapymentioning

confidence: 99%

Section: Bariatric Surgerymentioning

confidence: 99%

Prevalence, Pathophysiology, Health Consequences and Treatment Options of Obesity in the Elderly: A Guideline

2012

View full text Add to dashboard Cite

show abstract

“…Since overweight and obesity can aggravate metabolic abnormalities and worsen diabetes symptoms, first-line therapies focus on life style interventions to reduce body weight potentially combined with antidiabetic medications to correct hyperglycemia (Dennett, Boye, & Yurgin, 2008;Peters, 2009). Although excess weight has a negative impact on health in persons with diabetes, some antidiabetic agents are associated with weight gain as a side effect (Peters, 2009;Bailey, 2011). Given this complex role that body weight plays in the cause and therapy of diabetes, it is important to appropriately account for the impact of changes in BMI on health-related quality of life (HRQL) in terms of health utilities when selecting between therapies or evaluating the costeffectiveness of different diabetes treatment options (Dennett, Boye, & Yurgin, 2008).…”

Section: Introductionmentioning

confidence: 99%

Estimation of the relationship between body mass index and EQ-5D health utilities in individuals with type 2 diabetes: Evidence from the population-based KORA studies

Hünger¹,

Schunk²,

Meisinger³

et al. 2012

Journal of Diabetes and its Complications

View full text Add to dashboard Cite

“…However, many of the weight management interventions for type 2 diabetes have limited effect (Norris et al ., 2005; Bailey, 2011). Bariatric surgery (BS) is one strategy to achieve greater and more sustained weight loss.…”

Section: Introductionmentioning

confidence: 99%

Weight loss surgery for non-morbidly obese populations with type 2 diabetes: is this an acceptable option for patients?

Summers

Elsey

Moore

et al. 2013

Prim Health Care Res Dev

View full text Add to dashboard Cite

AimTo explore the views of non-morbidly obese people (BMI 30–40 kg/m2) with type 2 diabetes regarding: (a) the acceptability of bariatric surgery (BS) as a treatment for type 2 diabetes, and (b) willingness to participate in randomised controlled trials comparing BS versus non-surgical intervention.BackgroundDespite weight management being a key therapeutic goal in type 2 diabetes, achieving and sustaining weight loss is problematic. BS is an effective treatment for people with morbid obesity and type 2 diabetes; it is less certain whether non-morbidly obese patients (BMI 30–39.9 kg/m2) with type 2 diabetes benefit from this treatment and whether this approach would be cost-effective. Before evaluating this issue by randomised trials, it is important to understand whether BS and such research are acceptable to this population.MethodsNon-morbidly obese people with type 2 diabetes were purposively sampled from primary care and invited to participate in semi-structured interviews. Interviews explored participants’ thoughts surrounding their diabetes and weight, the acceptability of BS and the willingness to participate in BS research. Data were analysed using Framework Analysis.

show abstract

The challenge of managing coexistent type 2 diabetes and obesity

Cited by 25 publications

References 31 publications

Prevalence, Pathophysiology, Health Consequences and Treatment Options of Obesity in the Elderly: A Guideline

Prevalence, Pathophysiology, Health Consequences and Treatment Options of Obesity in the Elderly: A Guideline

Estimation of the relationship between body mass index and EQ-5D health utilities in individuals with type 2 diabetes: Evidence from the population-based KORA studies

Weight loss surgery for non-morbidly obese populations with type 2 diabetes: is this an acceptable option for patients?

Contact Info

Product

Resources

About