Comprehensive approach in the management of patients with diabesity


Authors: Ľubomíra Fábryová
Authors‘ workplace: Metabol KLINIK s. r. o., Bratislava – Ambulancia pre diabetológiu, poruchy látkovej premeny a výživy, Špecializovaná lipidologická ambulancia, MED PED centrum
Published in: Forum Diab 2018; 7(1): 0
Category:

Overview

Obesity is currently a global epidemic (pandemic) and the most common metabolic disorder affecting not only adults but also children and adolescents worldwide. Together with the increase in obesity, the number of type 2 diabetic patients is increasing, and we are talking about diabesity, which is becoming a real problem in our clinical practice. Weight reduction leads to significant improvement in cardiometabolic risk factors in obese type 2 diabetics. The current recommendations for the treatment of obese diabetic patients call for complex personalized medicine: the combination of non-pharmacological treatment (diet, physical activity, behavioral therapy), medication treatment (antidiabetic drugs, antiobesity drugs), but in the indicated cases also bariatric/metabolic surgery.

Key words:
antidiabetics, antiobesity therapy, bariatric/metabolic surgery, diabesity, no­n-pharmacological therapy obesity, overweight

Received:
14. 1. 2018

Accepted:
5. 2. 2018


Sources

1. Národné centrum zdravotníckych informácií. Činnosť diabetologických ambulancií 2016. ZŠ-11/2017. Dostupné z WWW: <http://www.nczi.sk>.

2. Fábryová Ľ. Farmakologická liečba obézneho diabetika 2. typu. In: Krahulec B, Fábryová Ľ, Holéczy P (eds) et al. Klinická obezitológia. Facta Medica: Brno 2013: 191–200. ISBN 978–80–904731–7-1.

3. Uerlich MF, Yumuk V, Finer N et al. Obesity Management in Europe: Current Status and Objectives for the Future. Obes Facts 2016; 9(4): 273–283. Dostupné z DOI: <http://dx.doi.org/10.1159/000445192>.

4. Hainer V, Tsigos C, Toplak H et al. Comment on the Paper by Uerlich et al: Obesity Management in Europe: Current Status and Objectivs for th Future. Obesity Facts 2016; 9(4): 273–283. Obes Facts 2016; 9(6): 392–396. Dostupné z DOI: <http://dx.doi.org/10.1159/000452249>.

5. Fábryová Ľ. Súčasná situácia v manažmente obéznych pacientov na Slovensku. Koncept národného komplexného manažmentu obezity v Slovenskej republike. Via Pract 2017; 14(6): 279–285.

6. Smatana M, Pažitný P, Kandilaki D et al. Slovakia: Health system review.Health Systems in Transition 2016; 18(6): 1–210. Dostupné z WWW: <http://www.healthobservatory.eu>.

7. Avdičová M, Francisciová K, Ďateľová M et al. Monitorovanie rizikových faktorov chronických chorôb v SR. Regionálny úrad verejného zdravotníctva so sídlom v Banskej Bystrici za podpory Svetovej zdravotníckej organizácie – regionálnej úradovne v Kodani, 2012. ISBN 978–80–971096–0-8.

8. Professional Practice Committee: Standards of Medical Care in Diabetes 2018. Diabetes Care 2018; 41(Suppl 1):S3. Dostupné z DOI: <https://doi.org/10.2337/dc18-SPPC01>.

9. Knowler WC, Barrett-Connor E, Fowler SE et al. [Diabetes Prevention Program Research Group]. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl JMed 2002; 346(6): 393–403. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa012512>.

10. [UK Prospective Diabetes Study 7]. UK Prospective Diabetes Study 7: response of fasting plasma glucose to diet therapy in newly presenting type II diabetic patients, UKPDS Group. Metabolism 1990; 39(9): 905–912.

11. Rothberg AE, McEwen LN, Kraftson AT et al. Very-low-energy diet for type 2 diabetes: an underutilized therapy? J Diabetes Complications 2014; 28(4): 506–510. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jdiacomp.2014.03.014>.

12. Wing RR, Bolin P, Brancati FL et al. LookmAHEAD Research Group. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med 2013; 369(2): 145–154. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1212914>. Erratum in N Engl J Med 2014; 370(19): 1866.

13. [Look AHEAD Research Group]. Eight-year weight losses with an intensive lifestyle intervention: the Look AHEAD study. Obesity (Silver Spring) 2014; 22(1): 5–13. Dostupné z DOI: <http://dx.doi.org/10.1002/oby.20662>.

14. Gudzune KA, Doshi RS, Mehta AK et al. Efficacy of commercial weight-loss programs: an updated systematic review. Ann Intern Med 2015;162(7): 501–512. Dostupné z DOI: <http://dx.doi.org/10.7326/M14–2238>. Erratum in Correction: Efficacy of commercial weight-loss programs. [Ann Intern Med 2015]

15. Cai X, Yang W, Gao X et al. Baseline body mass index and the efficacy of hypoglycemic treatment in type 2 diabetes: a metaanalysis. PLoS One 2016; 11(12): e0166625. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0166625>.

16. Fábryová Ľ. Weight Loss Pharmacotherapy of Obese Non-Diabetic and Type 2 Diabetic Patients. J Obes Weight Loss Ther 2015; 5: 277. Dostupné z DOI: <http://dx.doi.org/10.4172/2165–7904.1000277>.

17. Liu SC, Tu YK, Chien MN et al. Effect of antidiabetic agents added to metformin on glycaemic control, hypoglycaemia and weight change in patients with type 2 diabetes: a network meta-analysis. Diabetes Obes Metab 2012; 14(9): 810–820. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1463–1326.2012.01606.x>.

18. Lorenz M, Evers A, Wagner M et al. Recent progress and future options in the development of GLP-1 receptor agonists for the treatment of diabesity. Bioorg Med Chem Lett 2013; 23(14):4011–4018. Dostupné z DOI: <http://dx.doi.org/10.1016/j.bmcl.2013.05.022>.

19. Schroner Z, Uličiansky V. Liečba diabetes mellitus 2. typu založená na účinku inkretínov. 2. ed. SchronerMED: Košice 2011. ISBN 9788097071479.

20. Schroner Z, Uličiansky V. Inhibítory SGLT2 – nová cesta v liečbe diabetes mellitus 2. typu. SchronerMED: Košice 2015. ISBN 978–80–8129–040–4.

21. De Fronzo RA. Combination therapy with GLP-1 receptor agonist and SGLT2 inhibitor. Diabetes Obes Metab 2017; 19(10) :1353–1362. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12982>.

22. Tkáč I. Miesto agnistov GLP-1 receptorov a inhibítorov SGLT2 v modernej liečbe diabetu 2. typu. Diabetes a obezita 2017; 34: 17–24.

23. Fried M, Yumuk V, Oppert JM et al. [European Association for the Study of Obesity; International Federation for the Surgery of Obesity – European Chapter]. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Facts 2013; 6(5): 449–468. Dostupné z DOI: <http://dx.doi.org/10.1159/000355480>.

24. Toplak H, Woodward E, Yumuk V. et al. 2014 EASO Position Statement on the Use of Anti-Obesity Drugs. Obes Facts 2015; 8(3): 166–174. Dostupné z DOI: <http://dx.doi.org/10.1159/000430801>.

25. Fábryová Ľ. Účinnosť a bezpečnosť moderných antiobezitík: najnovšie dôkazy a manažment pacientov. Interná Med 2016; 16 (11): 447–454.

26. Ali KF, Shukla AP, Aronne LJ. Bupropion-SR plus naltrexone-SR for the treatment of mild-to-moderate obesity.Expert Rev Clin Pharmacol. 2016; 9(1): 27–34. Dostupné z DOI: <http://dx.doi.org/10.1586/17512433.2016.1100072>.

27. Greenway FL, Fujioka K, Plodkowski RA et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2010; 376(9741): 595–605. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(10)60888–4>. Erratum in Lancet 2010; 376(9741): 594. Lancet 2010; 376(9750): 1392.

28. Apovian CM, AronneL, Rubino D et al. COR-II Study Group. A randomized, phase 3 trial of naltrexoneSR/bupropôion SR on weight and obesity-related risk factors (COR-II). Obesity (Silver Spring) 2013; 21(5): 935–943. Dostupné z DOI: <http://dx.doi.org/10.1002/oby.20309>.

29. Hollande P, Gupta AK, Plodkowski R et al. [COR-Diabetes Study Group]. Effects of naltrexone/bupropion sustained-release combination therapy on body weight and glycemic parameters in overweight and obese patients with type 2 diabetes. Diabetes Care 2013: 36(12): 4022–4029. Dostupné z DOI: <http://dx.doi.org/10.2337/dc13–0234. Erratum in Diabetes Care 2014; 37(2): 587.

30. Wadden TA, Foreyt JP, Foster GD et al. Weight loss with naltrexone SR/bupropion SR combination therapy as an adjunct to behavior modification: The COR–BMOD Trial. Obesity (Silver Spring) 2011;19(1):110–120. Dostupné z DOI:

31. Consensus Development Conference Panel. NIH conference. Gastrointestinal surgery for severe obesity. Ann Intern Med 1991; 115(12): 956–961.

32. Holst JJ, Gribble F, Horowitz M, Rayner CK. Roles of the gut in glucose homeostasis. Diabetes Care 2016; 39(6): 884–892. Dostupné z DOI: <http://dx.doi.org/10.2337/dc16–0351>.

33. Batterham RL, Cummings DE. Mechanisms of Diabetes Improvement Following Bariatric/Metabolic Surgery. Diabetes Care 2016;39(6):893–901. Dostupné z DOI: <http://dx.doi.org/10.2337/dc16–0145>.

34. Rubino F, Kaplan LM, Schauer PRet al. [Diabetes Surgery Summit Delegates]. The Diabetes Surgery Summit consensus conference: recommendations for the evaluation and use of gastrointestinal surgery to treat type 2 diabetes mellitus. Ann Surg 2010; 251(3): 399–405. Dostupné z DOI: <http://dx.doi.org/10.1097/SLA.0b013e3181be34e7>.

35. Cummings DE, Cohen RV. Beyond BMI: the need for new guidelines governing the use of bariatric and metabolic surgery. Lancet Diabetes Endocrinol 2014;2(2):175–181.Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(13)70198–0>.

36. Rubino F, Nathan DM, Eckel RH et al. [Delegates of the 2nd Diabetes Surgery Summit]. Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. Diabetes Care 2016; 39(6): 861–877. Dostupné z DOI: <http://dx.doi.org/10.2337/dc16–0236>.

37. Holéczy P. Metabolická chirurgia – chirurgia obezity. Via Pract 2016; 13(1): 8–12. Dostupné z WWW: <http://obesitas.sk/wp-content/uploads/2016/08/VIA_1_2016_final_holeczy.pdf>.

38. Frühbeck G. Bariatric and metabolic surgery: a shift in eligibility and success criteria. Nat Rev Endocrinol 2015;11(8): 465–477. Dostupné z DOI: <http://dx.doi.org/10.1038/nrendo.2015.84>.

39. Sjöström L, Peltonen M, Jacobson P et al.Association of Bariatric Surgery With Long-term Remission of Type 2 Diabetes and With Microvascular and Macrovascular Complications. JAMA 2014; 311(22): 2297–2304. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2014.5988>.

40. Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial – a prospective controlled intervention study of bariatric surgery. J Intern Med 2013; 273(3): 219–234. Dostupné z DOI: <http://dx.doi.org/10.1111/joim.12012>.

Labels
Diabetology Endocrinology Internal medicine
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account