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检查 2 型糖尿病个体体重管理的证据。

Examining the evidence for weight management in individuals with type 2 diabetes.

机构信息

University of Alabama at Birmingham, UAB Diabetes Research Center, Birmingham, Alabama.

Emory University, Atlanta, Georgia.

出版信息

Diabetes Obes Metab. 2022 Aug;24(8):1411-1422. doi: 10.1111/dom.14764. Epub 2022 May 30.

Abstract

The obesity epidemic has been linked to the worsening diabetes epidemic. Despite this, weight reduction for individuals with obesity is seen as a secondary, or even tertiary, consideration in the treatment of type 2 diabetes (T2D). The aim of this review is to examine the benefits of weight management in individuals with T2D. A literature review of current available published data on the benefits of weight reduction in individuals with T2D was conducted. In individuals with T2D who have obesity or overweight, modest and sustained weight reduction results in improvement in glycaemic control and decreased utilization of glucose-lowering medication. A total body weight loss of 5% or higher reduces HbA1c levels and contributes to mitigating risk factors of cardiovascular disease, such as hyperlipidaemia and hypertension, as well as other disease-related complications of obesity. Progressive improvements in glycaemic control and cardiometabolic risk factors can occur when the total body weight loss increases to 10% or more. In the approach to treating patients with T2D and obesity, prioritizing weight management and the use of therapeutics that offer glycaemic control as well as the additional weight loss should be emphasized given their potential to attenuate the progression and severity of T2D.

摘要

肥胖症的流行与糖尿病的恶化有关。尽管如此,减轻肥胖症患者的体重在治疗 2 型糖尿病(T2D)时被视为次要的,甚至是第三考虑的。本综述旨在探讨体重管理对 T2D 患者的益处。对目前关于 T2D 患者减轻体重益处的已发表数据进行了文献综述。对于肥胖或超重的 T2D 患者,适度且持续的体重减轻可改善血糖控制并减少降糖药物的使用。体重减轻 5%或更多可降低 HbA1c 水平,并有助于减轻血脂异常和高血压等心血管疾病的危险因素,以及肥胖相关的其他疾病并发症。当体重减轻增加到 10%或更多时,血糖控制和心血管代谢危险因素会逐渐改善。在治疗 T2D 和肥胖症患者时,鉴于其可能减缓 T2D 的进展和严重程度,应优先考虑体重管理和使用既能控制血糖又能额外减轻体重的治疗方法。

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