Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
Department of Diabetes, Nutrition and Metabolic Disorders and Clinical Pharmacology Unit, University of Liège, Liège, Belgium.
Diabetes Care. 2015 Jun;38(6):1161-72. doi: 10.2337/dc14-1630.
Diabetes is a growing global health concern, as is obesity. Diabetes and obesity are intrinsically linked: obesity increases the risk of diabetes and also contributes to disease progression and cardiovascular disease. Although the benefits of weight loss in the prevention of diabetes and as a critical component of managing the condition are well established, weight reduction remains challenging for individuals with type 2 diabetes due to a host of metabolic and psychological factors. For many patients, lifestyle intervention is not enough to achieve weight loss, and alternative options, such as pharmacotherapy, need to be considered. However, many traditional glucose-lowering medications may lead to weight gain. This article focuses on the potential of currently available pharmacological strategies and on emerging approaches in development to support the glycemic and weight-loss goals of individuals with type 2 diabetes. Two pharmacotherapy types are considered: those developed primarily for blood glucose control that have a favorable effect on body weight and those developed primarily to induce weight loss that have a favorable effect on blood glucose control. Finally, the potential of combination therapies for the management of obese patients with type 2 diabetes is discussed.
糖尿病和肥胖症都是全球性的健康问题。糖尿病和肥胖症密切相关:肥胖症会增加患糖尿病的风险,也会导致疾病进展和心血管疾病。尽管减肥对于预防糖尿病和作为管理病情的关键组成部分的益处已得到充分证实,但由于多种代谢和心理因素,2 型糖尿病患者减肥仍然具有挑战性。对于许多患者来说,生活方式干预不足以实现减肥,因此需要考虑其他选择,如药物治疗。然而,许多传统的降血糖药物可能会导致体重增加。本文重点介绍了目前可用的药理学策略的潜力和正在开发的新方法,以支持 2 型糖尿病患者的血糖和减肥目标。考虑了两种药物治疗类型:主要用于血糖控制且对体重有有利影响的药物和主要用于诱导体重减轻且对血糖控制有有利影响的药物。最后,还讨论了联合疗法在肥胖 2 型糖尿病患者管理中的应用潜力。