Garber Alan J
Endocr Pract. 2015 Jun;21(6):634-44. doi: 10.4158/EP14460.RA. Epub 2015 Feb 25.
Type 2 diabetes and its associated complications place heavy burdens on affected individuals, their caregivers, and society. The prevalence of type 2 diabetes is increasing worldwide. Attempts to combat this problem have been extended to the treatment of obesity and prevention of progression from prediabetes to type 2 diabetes. As such, weight loss is an important component of type 2 diabetes prevention. However, successful strategies for achieving sustained weight loss have remained elusive. Although lifestyle modification remains a cornerstone of this approach, it has become clear that changes to lifestyle alone will not suffice for many patients. A pragmatic approach includes consideration of pharmacotherapeutic options.
This review discusses the different pharmacotherapeutic options for the treatment of obesity and prediabetes.
Approved anti-obesity therapies and antihyperglycemic agents associated with weight loss may prove effective earlier in the treatment paradigm, and other promising agents that are in clinical development for chronic weight management show promise for both weight reduction and a reduction in the risk of type 2 diabetes in high-risk individuals.
Long-term evaluation of safety and efficacy is required for many of these agents before we can begin to optimize their use in clinical practice, but treatment choices for obese or prediabetic patients are increasing.
2型糖尿病及其相关并发症给患者本人、其护理人员及社会带来了沉重负担。2型糖尿病在全球的患病率正在上升。应对这一问题的努力已扩展到肥胖症治疗及预防糖尿病前期进展为2型糖尿病。因此，体重减轻是2型糖尿病预防的重要组成部分。然而，实现持续体重减轻的成功策略仍难以捉摸。尽管生活方式改变仍是该方法的基石，但很明显，仅靠生活方式改变对许多患者来说并不够。一种务实的方法包括考虑药物治疗选择。
本综述讨论了治疗肥胖症和糖尿病前期的不同药物治疗选择。
已批准的与体重减轻相关的抗肥胖疗法和降糖药物可能在治疗模式中更早显示出效果，其他正在进行慢性体重管理临床开发的有前景的药物对高危个体的体重减轻和2型糖尿病风险降低均显示出前景。
在我们能够开始优化这些药物在临床实践中的使用之前，许多此类药物需要进行长期安全性和有效性评估，但肥胖或糖尿病前期患者的治疗选择正在增加。
