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Management of Obesity in Diabetes

Management of Obesity in Diabetes. Key Messages An estimated 80 to 90% of persons with type 2 diabetes are overweight or obese. A modest weight loss of 5 to 10% of initial body weight can substantially improve insulin sensitivity and glycemic, blood pressure and lipid control.

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Management of Obesity in Diabetes

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  1. Management of Obesity in Diabetes Key Messages • An estimated 80 to 90% of persons with type 2 diabetes are overweight or obese. • A modest weight loss of 5 to 10% of initial body weight can substantially improve insulin sensitivity and glycemic, blood pressure and lipid control.

  2. Management of Obesity in Diabetes Key Messages • A comprehensive healthy lifestyle intervention program should be implemented in overweight and obese people with diabetes to achieve and maintain a healthy body weight. The addition of a pharmacologic agent should be considered for appropriate overweight or obese adults who are unable to attain clinically important weight loss with lifestyle modification. • Adults with severe obesity may be considered for bariatric surgery when other interventions fail to result in achieving weight goals.

  3. Management of Obesity in Diabetes 2008 CPG Recommendations • A comprehensive healthy lifestyle intervention program (including a hypocaloric, nutritionally balanced diet, regular physical activity or exercise, and behavioural modification techniques) for overweight and obese people with, or at risk for diabetes, should be implemented to achieve and maintain a healthy body weight [Grade D, Consensus]. Members of the healthcare team should consider using a structured approach to providing advice and feedback on physical activity, healthy eating habits and weight loss [Grade C, Level 3 (31-34)].

  4. Management of Obesity in Diabetes 2008 CPG Recommendations • In overweight or obese adults with type 2 diabetes, a pharmacologic agent such as orlistat [Grade A, Level 1A (26)] or sibutramine [Grade B, Level 2 (37)] should be considered as an adjunct to lifestyle modifications to facilitate weight loss and improve glycemic control. • Adults with class III obesity (BMI ≥ 40.0 kg/m2) or class II obesity (BMI 35.0 to 39.9 kg/m2) with other comorbidities may be considered for bariatric surgery when other lifestyle interventions are inadequate in achieving weight goals [Grade C, Level 3 (43)].

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