Via practica 5/2020

Antiobesity drugs in the management of obese type 2 diabetic patients

According to current statistics from around the world, the rate of obesity/diabesity is very unlikely to decrease, while the group of patients with BMI ≥ 40 kg/m2 is growing relatively fast. Obesity/diabesity is insufficiently treated, due to the fact that in many countries, obesity is not recognized as a chronic lifelong disease, thus denying to obese patients the right to real help. Obesity generates other chronic diseases, not only cardiometabolic (type 2 diabetes mellitus, arterial hypertension, adiposopathic dyslipidemia, myocardial infarction, stroke, heart rhythm disorders...), but also cancer and neurodegenerative (Alzheimer‘s and Parkinson‘s disease). We are not only concerned with weight loss (glycaemia, adjustment of lipid spectrum, blood pressure), but ultimately a reduction in cardiovascular risk factors, cardiovascular events, as well as a decrease in cardiovascular and overall mortality. Clinical studies to date have shown that weight loss leads to a rapid reduction in cardiovascular risk factors, but so far, we do not have any study that would clearly show that weight loss does not increase, respectively leads to a reduction in cardiovascular morbidity and mortality. At present, we lack both primary and secondary prevention of obesity with subsequent curation. Only 1 % of obese patients receive real help in the management of obesity/diabesity and even more importantly the management of already reduced weight (diet and regimen measures, cognitive-behavioral therapy, pharmacotherapy, bariatric/metabolic surgery).

Keywords: obesity, diabesity, pharmacotherapy of obesity/diabesity, liraglutide 3.0 mg, naltrexone SR/bupropion SR, semaglutide