Via practica 7-8/2008

WEIGHT MANAGEMENT FOR OBESE TYPE 2 DIABETICS

The prevalence of obesity and type 2 diabetes is increasing in the world. Obesity and weight gain are major risk factors for type 2 diabetes. Up to 80 % of patients with type 2 diabetes are overweight or obese and obesity worsens the metabolic and physiologic abnormalities associated with diabetes, particularly hyperglycemia, hyperlipidemia and hypertension. Obesity is viewed as a chronic disease and optimal management may required long-term agressive non-pharmacological and pharmacological therapy. In patients in whom behavioral therapy has failed, adjunctive treatment with weigh-management drugs may help reduce or maintain weight and improve other health parameters. Despite the emphasis placed on weight loss in overweigh and obese type 2 diabetics, many widely used antidiabetic treatments are associated with weight gain. Drugs that are weight neutral or promote weight loss should be the first option in these patients.

Keywords: type 2 diabetes, sibutramine, orlistat, rimonabant, antidiabetic treatment, incretine based therapy.