Disclosure JPHW has received research support from Bristol Myers Squibb, AstraZeneca & Merck Sharpe and Dohme. He has acted as an advisor/consultant to Astellas, AstraZeneca, Boehringer-Ingleheim, Bristol Myers Squibb, Lilly, NovoNordisk, Sanofi, & Takeda and has given lectures on behalf of AstraZeneca, Boehringer-Ingleheim, Bristol Myers Squibb, Lilly, Merck Sharpe & Dohme, & NovoNordisk. The author was fully responsible for all content and editorial decisions, was involved at all stages of manuscript development and has approved the final version of the review that reflects the author's interpretation and conclusions.
The importance of weight management in type 2 diabetes mellitus
Version of Record online: 18 FEB 2014
© 2014 The Authors International Journal of Clinical Practice Published by John Wiley & Sons Ltd
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
International Journal of Clinical Practice
Volume 68, Issue 6, pages 682–691, June 2014
How to Cite
Wilding, J. P. H. (2014), The importance of weight management in type 2 diabetes mellitus. International Journal of Clinical Practice, 68: 682–691. doi: 10.1111/ijcp.12384
- Issue online: 18 MAY 2014
- Version of Record online: 18 FEB 2014
- Manuscript Accepted: DEC 2013
- Manuscript Received: OCT 2013
- Boehringer Ingelheim
The obesity epidemic is driving the increased prevalence of type 2 diabetes mellitus (T2DM), and the vast majority of patients with T2DM are overweight or obese. Excess body weight is associated with the risk of cardiometabolic complications, which are major causes of morbidity and mortality in T2DM.
To review evidence about effects of weight loss in pre-diabetes and established T2DM.
In prediabetes, weight loss has been shown to delay the onset or decrease the risk of T2DM, while in established T2DM weight loss has been shown to improve glycaemic control, with severe calorie restriction even reversing the progression of T2DM. Observational studies support the reduction in cardiovascular risk factors following weight loss in patients with T2DM. However, data from the randomised Look AHEAD trial revealed intensive weight loss interventions did not reduce the rate of cardiovascular events in overweight or obese adults with T2DM, and secondary analyses of other large cardiovascular outcomes trials have also been inconclusive. However, besides cardiovascular risk, other documented benefits of weight loss in T2DM include improvements in quality of life, mobility, and physical and sexual function.
Physicians should encourage weight loss in all overweight patients with or at risk of T2DM, and should consider the impact on weight when choosing the most appropriate glucose-lowering therapies for these patients.