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2型糖尿病患者的体重管理与血糖目标——我们取得了多大进展?

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

作者信息

Blüher Matthias, Ceriello Antonio, Davies Melanie, Rodbard Helena, Sattar Naveed, Schnell Oliver, Tonchevska Elena, Giorgino Francesco

机构信息

Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany.

Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig, Leipzig, Germany.

出版信息

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

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.

摘要

引言

由于绝大多数2型糖尿病(T2D)患者同时超重或肥胖,医疗保健专业人员(HCP)面临着体重管理和血糖控制两项任务。在这篇叙述性综述中,我们旨在确定T2D患者实现并维持体重目标所面临的挑战,并强调当前及未来的治疗干预措施。

方法

使用搜索词“糖尿病”和“体重减轻”对PubMed数据库进行检索。

结果

根据新出现的证据,治疗肥胖可能先于T2D的发生和发展。虽然通常在体重减轻3-5%时开始显现临床益处,但这些益处是渐进性的,会带来进一步的健康改善,且体重减轻>15%对T2D患者可能具有疾病改善作用,而这一结果直至最近都无法通过任何降糖药物疗法实现。然而,目前正在研发的具有减肥作用的先进治疗方案,包括双重GIP/GLP-1受体激动剂,可能使患者同时实现个体血糖和体重目标。

结论

尽管治疗取得了显著进展,但仍有大量T2D患者未达到个体化血糖和减肥目标,存在尚未满足的医疗需求。尽管如此,可以预期未来疗法的研发及其应用将有利地改变T2D患者体重和血糖控制的局面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/28b4/9094453/8f9f19c67a35/EDM2-5-e00330-g001.jpg

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