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Review
. 2022 May;5(3):e00330.
doi: 10.1002/edm2.330. Epub 2022 Mar 17.

Managing weight and glycaemic targets in people with type 2 diabetes-How far have we come?

Matthias Blüher  1   2 , Antonio Ceriello  3 , Melanie Davies  4   5 , Helena Rodbard  6 , Naveed Sattar  7 , Oliver Schnell  8   9 , Elena Tonchevska  8 , Francesco Giorgino  10
Affiliations
Review

Managing weight and glycaemic targets in people with type 2 diabetes-How far have we come?

Matthias Blüher et al. Endocrinol Diabetes Metab. 2022 May.

Abstract

Introduction: As the vast majority of people with type 2 diabetes (T2D) are also overweight or obese, healthcare professionals (HCP) are faced with the task of addressing both weight management and glucose control. In this narrative review, we aim to identify the challenges of reaching and maintaining body weight targets in people with T2D and highlight current and future treatment interventions.

Methods: A search of the PubMed database was conducted using the search terms "diabetes" and "weight loss."

Results: According to emerging evidence, treating obesity may be antecedent to the development and progression of T2D. While clinical benefits typically set in upon achieving a weight loss of 3-5%, these benefits are progressive leading to further health improvements, and weight loss of >15% can have a disease-modifying effect in people with T2D, an outcome that up to recently could not be achieved with any blood glucose-lowering pharmacotherapy. However, advanced treatment options with weight-loss effects currently in development including the dual GIP/GLP-1 receptor agonists may enable simultaneous achievement of individual glycemic and weight goals.

Conclusion: Despite considerable therapeutic progress, there is still a large unmet medical need in patients with T2D who miss their individualized glycemic and weight-loss targets. Nonetheless, it is to be expected that development of future therapies and their use will favourably change the scenario of weight and glucose control in T2D.

Keywords: HbA1c; treatment; type 2 diabetes; weight loss.

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Conflict of interest statement

Prof. Mathias Blüher has received honoraria as a consultant and speaker from Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi‐Sankyo, Lilly, Novo Nordisk, Novartis, Pfizer and Sanofi. Prof. Antonio Ceriello has been involved in Advisory Boards, Lectures and Consultancy by the following companies: Astra Zeneca, Berlin Chemie, Eli Lilly, Novo Nordisk, Italian Ministry of Health—Ricerca Finalizzata, Mitsubishi, Roche Diagnostics and Theras. Dr. Helena Rodbard has consulted for and received research support by Bayer, Boehringer Ingelheim, Eli Lilly, Merck, Novo Nordisk, Regeneron, Sanofi, Vivus and Zealand. Prof. Naveed Sattar has consulted for Afimmune, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Hanmi Pharmaceuticals, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer and Sanofi; and received grant support paid to his University from AstraZeneca, Boehringer Ingelheim, Novartis and Roche Diagnostics outside the submitted work. Prof. Oliver Schnell is a founder and CEO of Sciarc GmbH. Elena Tonchevska is an employee of Sciarc GmbH. Prof. Melanie Davies and Prof. Fracesco Giorgino have not reported any conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Overview on biological GIP and GLP‐1 effects at the organ/tissue level
FIGURE 2
FIGURE 2
Physiological effects of GLP‐1 RAs, GCGR agonists and dual GLP‐1 R/GCGR agonists on different organs and tissues (pancreas, liver, brain, brown adipose tissue, muscle, adipose tissue and circulation system). FAO, fatty acid oxidation; GSIS, glucose‐stimulated insulin secretion). Adapted from
See this image and copyright information in PMC

References

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    1. Davies MJ, D’Alessio DA, Fradkin J, et al. Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018;41(12):2669‐2701. - PMC - PubMed