62
VOLUME 17 NUMBER 2 • NOVEMBER 2020
Report
SA JOURNAL OF DIABETES & VASCULAR DISEASE
Key learnings
• Insulin resistance and obesity each give rise to the other, potentially
resulting in more severe obesity and T2DM.
• Weight reduction is considered a key therapeutic goal in the treatment of
T2DM, demonstrating numerous beneficial health effects.
• Metabolic surgery is the best treatment option for patients with diabesity,
although most patients can only be managed with combined lifestyle
interventions and antidiabetic medications.
• Of the available antidiabetic medications, GLP-1 RAs are associated with
the greatest weight loss, with variation among individual GLP-1 RAs and in
different patient groups.
• The thiazolidinediones, insulin and sulphonylureas are associated with
weight gain.
• Medications for treatment of other conditions may increase body weight.
References
1. Leitner DR, Fruhbeck G, Yumuk V,
et al
. Obesity and type 2 diabetes. Two diseases
with a need for combined treatment strategies – EASO can lead the way.
Obes
Facts
2017;
10
(5): 483–492.
2. Garcia-Jiminez C, Gutierrez-Salmeron M, Chocarro-Calvo A,
et al
. From obesity
to diabetes and cancer: Epidemiological links and role of therapies.
Br J Cancer
2016;
114
(7): 716–722.
3. Duclos M. Osteoarthritis, obesity and type 2 diabetes: The weight of waist
circumference.
Ann Phys Rehabil Med
2016;
59
(3): 157–160.
4. Apicella M, Campopiano M, Mantuano M,
et al
. COVID-19 in people with
diabetes: Understanding the reasons for worse outcomes.
Lancet Diabetes
Endocrinol
2020 [Epub ahead of print].
5. Igel LI, Saunders KH, Fins JJ. Why weight? An analytic review of obesity
management, diabetes prevention, and cardiovascular risk reduction.
Curr
Atheroscler Rep
2018;
20
(8): 39.
6. Verma S, Hussain ME. Obesity and diabetes: An update.
Diabetes Metab Syndr
2017;
11
(1): 73–79.
7. Lindstrom J, Louheranta A, Mannelin M,
et al
. The Finnish Diabetes Prevention
Study (DPS): Lifestyle intervention and 3-year results on diet and physical activity.
Diabetes Care
2003;
26
(12): 3230–3236.
8. Diabetes Prevention Program Research Group. Reduction in incidence of type 2
diabetes with lifestyle intervention or metformin.
N Engl J Med
2002;
346
(6):
393–403.
9. Wing RR, Lang W, Wadden TA,
et al
. Benefits of modest weight loss in improving
cardiovascular risk factors in overweight and obese individuals with type 2
diabetes.
Diabetes Care
2011;
34
(7): 1481–1486.
10. Look AHEAD Research Group. Long-term effects of a lifestyle intervention on
weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus:
four-year results of the Look AHEAD trial.
Arch Intern Med
2010;
170
(17): 1566–
1575.
11. Rubin RR, Wadden TA, Bahnson JL,
et al
. Impact of intensive lifestyle intervention
on depression and health-related quality of life in type 2 diabetes: The Look
AHEAD Trial.
Diabetes Care
2014;
37
(6): 1544–1553.
12. Foster GD, Borradaile KE, Sanders MH,
et al
. A randomized study on the effect
of weight loss on obstructive sleep apnea among obese patients with type 2
diabetes: the Sleep AHEAD study.
Arch Intern Med
2009;
169
(17): 1619–1626.
13. Boles A, Kandimalla R, Reddy PH. Dynamics of diabetes and obesity:
Epidemiological perspective.
Biochim Biophys Acta Mol Basis Dis
2017;
1863
(5):
1026-1036.
14. Wharton S, Lau DCW, Vallis M,
et al
. Obesity in adults: a clinical practice guideline.
CMAJ 2020; 192: E875–891.
15. Pappachan JM, Fernandez CJ, Chacko EC. Diabesity and antidiabetic drugs.
Mol
Aspects Med
2019;
66
: 3–12.
16. Pi-Sunyer X, Astrup A, Fujioka K,
et al
. A randomized, controlled trial of 3.0 mg
of liraglutide in weight management.
N Engl J Med
2015;
373
(1): 11–22.
17. Dungan KM, Povedano ST, Forst T,
et al
. Once-weekly dulaglutide versus once-
daily liraglutide in metformin-treated patients with type 2 diabetes (AWARD-6):
a randomised, openlabel, phase 3, non-inferiority trial.
Lancet
2014;
384
(9951):
1349–1357.
18. Dushay J, Mitten EK, Gao C,
et al
. Short-term exenatide treatment leads to
significant weight loss in a subset of obese women without diabetes.
Diabetes
Care
2012;
35
: 4–11.
19. Christou GA, Katsiki N, Blundell J,
et al
. Semaglutide as a promising antiobesity
drug.
Obes Rev
2019;
20
(6): 805–815.
20. Farzi A, Hassan AM, Zenz G,
et al
. Diabesity and mood disorders: Multiple links
through the microbiota-gut-brain axis.
Mol Aspects Med
2019;
66
: 80-93.
21. Jantaratnotai N, Mosikanon K, Lee Y,
et al
. The interface of depression and
obesity.
Obes Res Clin Pract
2017;
11
(1): 1–10.
DYNATOR 10, 20, 40, 80 mg.
Each tablet contains 10, 20, 40, 80 mg atorvastatin respectively. S4
A43/7.5/0167, 0168, 0169, 0170. NAM NS2 13/7.5/0111, 0112, 0113, 0114. For full prescribing information,
refer to the professional information approved by SAHPRA, 02 June 2017.
1)
Klug E,
et al.
South African
dyslipidaemia guideline consensus statement.
S Afr Med J
. 2012;102:177-188.
DRB625/10/2019.
CUSTOMER CARE LINE
0860 PHARMA (742 762) / +27 21 707 7000
www.pharmadynamics.co.za“Intensive management
of dyslipidaemia in
South Africa will
significantly reduce the
cardiovascular disease
health burden”
1