PMID- 21599553
OWN - NLM
STAT- MEDLINE
DCOM- 20111101
LR  - 20220330
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 27
IP  - 7
DP  - 2011 Jul
TI  - Impact of weight gain on outcomes in type 2 diabetes.
PG  - 1431-8
LID - 10.1185/03007995.2011.585396 [doi]
AB  - BACKGROUND: The majority of patients with type 2 diabetes mellitus (T2DM) are 
      overweight or obese. Obesity is a significant risk factor for increased morbidity 
      and mortality in people with T2DM, and increased weight has been shown to worsen 
      glycemic control and increase the risk of diabetes progression. METHODS: A search 
      was conducted of the National Library of Medicine (PubMed) for articles published 
      from 1990 to 2009 about the treatments of T2DM, relationship between T2DM and 
      weight gain, obesity-related comorbidities of T2DM, and T2DM therapies associated 
      with increased weight. Reference lists of retrieved articles were reviewed for 
      additional publications. FINDINGS: Results from large, prospective clinical 
      trials have shown that weight reduction significantly improves glycemic control 
      and blood pressure in T2DM patients and lowers the risk of progression of T2DM as 
      well as CV disease and cancer. Treatment-related weight gain is a side effect of 
      many oral antidiabetes agents and insulin. The thiazolidinediones (TZD), 
      sulfonylureas, and glinides are associated with weight gain. Despite the weight 
      gain, TZDs also redistribute fat from the central to peripheral compartments, 
      which may lead to a beneficial effect on insulin resistance. Among insulin 
      products, the basal insulin analog detemir is typically associated with a smaller 
      weight increase than human insulin and insulin analog preparations, including 
      glargine, biphasic, and prandial insulin regimens. Alpha-glucosidase inhibitors 
      and dipeptidyl peptidase-4 inhibitors are weight neutral, whereas glucagon-like 
      peptide1-R agonists and metformin are associated with weight loss. DISCUSSION: An 
      effective approach to management of the obese patient with diabetes is to 
      communicate the significant benefits of a 1 kg reduction in body weight or 
      prevention of weight gain on glycemic control and reduced morbidity and 
      mortality. LIMITATION: This article is based on an extensive literature review 
      rather than the prospective studies needed to define further the effect of weight 
      gain on the management of T2DM. CONCLUSION: Weight management should be an 
      integral part of a T2DM treatment strategy that includes selecting oral 
      antidiabetes medications and insulin products that are weight beneficial.
FAU - Ross, Stuart A
AU  - Ross SA
AD  - Clinical Professor of Medicine, University of Calgary, Calgary, Alberta, Canada. 
      drross@telus.net
FAU - Dzida, Grzegorz
AU  - Dzida G
FAU - Vora, Jiten
AU  - Vora J
FAU - Khunti, Kamlesh
AU  - Khunti K
FAU - Kaiser, Marcel
AU  - Kaiser M
FAU - Ligthelm, Robert J
AU  - Ligthelm RJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20110523
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
SB  - IM
MH  - Comorbidity
MH  - Diabetes Mellitus, Type 2/complications/epidemiology/mortality/*therapy
MH  - Humans
MH  - Models, Biological
MH  - Obesity/complications/epidemiology
MH  - Overweight/complications/epidemiology
MH  - Treatment Outcome
MH  - Weight Gain/*physiology
EDAT- 2011/05/24 06:00
MHDA- 2011/11/02 06:00
CRDT- 2011/05/24 06:00
PHST- 2011/05/24 06:00 [entrez]
PHST- 2011/05/24 06:00 [pubmed]
PHST- 2011/11/02 06:00 [medline]
AID - 10.1185/03007995.2011.585396 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2011 Jul;27(7):1431-8. doi: 10.1185/03007995.2011.585396. Epub 
      2011 May 23.