Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece.
Diabetes Obes Metab. 2009 Jul;11(7):641-64. doi: 10.1111/j.1463-1326.2008.01026.x. Epub 2009 Feb 18.
Obesity is considered as a major health problem, as its prevalence continuously rises worldwide. One of the common health consequences of obesity is type 2 diabetes mellitus. Therefore, antiobesity management is a prerequisite in treating diabetic patients. Lifestyle modifications combined with pharmacological agents appear to be an effective approach. Sibutramine is a serotonin-noradrenaline reuptake inhibitor, which acts centrally by promoting the feeling of satiety and decreasing caloric intake, thus resulting in weight loss. A potential association with cardiovascular side effects has been noted. Orlistat, a gastric and pancreatic lipase inhibitor, also achieves significant weight loss and improves glycaemic status, but it has gastrointestinal side effects. Rimonabant, the first endocannabinoid CB1 antagonist, is associated with weight reduction and it improves diabetic parameters; nevertheless, it is associated with psychiatric disorders; indeed, a recently conducted safety review led to the temporal suspension of its commercialization. The above-mentioned medications seem to be currently useful agents for treating obesity in patients with type 2 diabetes mellitus. Other medications used for diabetes management, such as exenatide, liraglutide and pramlintide, have also shown body weight reduction. Ongoing research is needed to scrutinize the precise impact of these agents in the daily clinical practice of management of obesity in patients with type 2 diabetes mellitus.
肥胖被认为是一个主要的健康问题,因为它在全球范围内的患病率不断上升。肥胖的常见健康后果之一是 2 型糖尿病。因此,抗肥胖管理是治疗糖尿病患者的前提。生活方式的改变结合药物治疗似乎是一种有效的方法。西布曲明是一种 5-羟色胺和去甲肾上腺素再摄取抑制剂,它通过促进饱腹感和减少热量摄入来发挥中枢作用,从而导致体重减轻。已经注意到它与心血管副作用之间存在潜在关联。奥利司他是一种胃和胰脂肪酶抑制剂,也能显著减轻体重并改善血糖状况,但它有胃肠道副作用。利莫那班是第一个内源性大麻素 CB1 拮抗剂,与体重减轻和改善糖尿病参数有关;然而,它与精神障碍有关;事实上,最近进行的安全性审查导致其暂时停止商业化。上述药物似乎是目前治疗 2 型糖尿病患者肥胖的有用药物。其他用于糖尿病管理的药物,如 exenatide、liraglutide 和 pramlintide,也显示出体重减轻的效果。需要进行正在进行的研究来仔细检查这些药物在 2 型糖尿病患者肥胖管理的日常临床实践中的精确影响。
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