Current Diabetes Reports

, 17:4

Medical Management of Diabesity: Do We Have Realistic Targets?

Pharmacologic Treatment of Type 2 Diabetes (HE Lebovitz and G Bahtiyar, Section Editors)

DOI: 10.1007/s11892-017-0828-9

Cite this article as:
Pappachan, J.M. & Viswanath, A.K. Curr Diab Rep (2017) 17: 4. doi:10.1007/s11892-017-0828-9
Part of the following topical collections:
  1. Topical Collection on Pharmacologic Treatment of Type 2 Diabetes

Abstract

Purpose of Review

The global prevalence of “diabesity”—diabetes related to obesity—is increasing steadily over the past few decades because of the obesity epidemic. Although bariatric surgery is an effective treatment option for patients with diabesity, its limited availability, invasiveness, relatively high costs and the potential for surgical and postsurgical complications restrict its widespread use. Therefore, medical management is the only option for a majority of patients with diabesity. Diabetes control with several anti-diabetic agents, including insulin, causes weight gain with probability of worsening diabesity. Rational use of anti-diabetic medications with weight loss potential in varying combinations may help to address this key issue for long-term management of diabesity. There is no consensus on such an approach from different professional bodies like American Diabetes Association, European Association for Study of Diabetes, or International Diabetes Federation. We attempt to discuss the key issues and realistic targets for diabesity management in this paper.

Recent Findings

Rational use of anti-diabetic combinations can mitigate worsening of diabesity to some extent while managing patients.

Summary

Retrospective studies showed that combination therapy with glucagon-like peptide-1 (GLP-1) receptor agonists and sodium glucose co-transporter 2 (SGLT-2) inhibitors, when administered along with other anti-diabetic medications, offer the best therapeutic benefit in the medical management of diabesity. Different combinations of other anti-diabetic drugs with minimum weight gain potential were also found useful. Because of insufficient evidence based on prospective randomised controlled trials (RCTs), future research should focus on evolving the appropriate rational drug combinations for the medical management of diabesity.

Keywords

Diabesity Anti-diabetic medication Anti-diabetic drug combination Anti-obesity agents Management of diabesity 

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of Endocrinology and Diabetes, Royal Lancaster InfirmaryUniversity Hospitals of Morecambe NHS TrustLancasterUK
  2. 2.Department of Endocrinology and Diabetes, New Cross HospitalThe Royal Wolverhampton Hospitals NHS TrustWolverhamptonUK