Weight Management in Type 2 Diabetes Mellitus

Authors

  • Amulya T. Siram,

    1. Department of Medicine, Division of Endocrinology, Diabetes, and Bone Diseases, Mount Sinai School of Medicine, New York, NY
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  • Robert Yanagisawa,

    1. Department of Medicine, Division of Endocrinology, Diabetes, and Bone Diseases, Mount Sinai School of Medicine, New York, NY
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  • Maria Skamagas MD

    Corresponding author
    1. Department of Medicine, Division of Endocrinology, Diabetes, and Bone Diseases, Mount Sinai School of Medicine, New York, NY
    • Department of Medicine Division of Endocrinology, Diabetes, and Bone Diseases Mount Sinai School of Medicine New York, NY.
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Abstract

Obesity is a well known risk factor for type 2 diabetes mellitus. Individuals with type 2 diabetes mellitus are at risk for weight gain as a result of multiple influences, including sedentary lifestyle, high-calorie diet, diabetes medications, sociocultural factors, chronic medical and psychiatric illnesses, and a dysregulated enteroendocrine axis. Because both diabetes mellitus and obesity predispose patients to abnormal cardiometabolic profiles and increased cardiovascular disease, management of diabetes mellitus should focus on weight management and optimizing cardiometabolic parameters, concomitant with glycemic control. Lifestyle modification incorporating healthy, calorie-appropriate diets and increased physical activity, in addition to metformin, are central components to diabetes management and weight management. These interventions have been shown to improve body weight, glycemic control, and overall cardiometabolic profile. The weight-neutral and weight-losing diabetes medications include metformin, alpha-glucosidase inhibitors, glucagon-like peptide-1 analogs, dipeptidyl peptidase-4 inhibitors, and amylin analogs. It is essential that providers understand the metabolic and weight effects of diabetes medications in order to develop strategies for managing diabetes mellitus while helping patients maintain or lose weight in order to improve their overall health outcomes. Mt Sinai J Med 77:533–548,2010. © 2010 Mount Sinai School of Medicine

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