Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized?
Data show that the insights that improve obesity prevention and treatment will almost certainly benefit the incidence and care of type 2 diabetes. Objective: This report examines what is known about the relationship between obesity and type 2 diabetes and how future research in these areas might be...
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description | Data show that the insights that improve obesity prevention and treatment will almost certainly benefit the incidence and care of type 2 diabetes.
Objective:
This report examines what is known about the relationship between obesity and type 2 diabetes and how future research in these areas might be directed to benefit prevention, interventions, and overall patient care.
Research Design and Methods:
An international working group of 32 experts in the pathophysiology, genetics, clinical trials, and clinical care of obesity and/or type 2 diabetes participated in a conference held on 6–7 January 2011 and cosponsored by The Endocrine Society, the American Diabetes Association, and the European Association for the Study of Diabetes. A writing group comprising eight participants subsequently prepared this summary and recommendations. Participants reviewed and discussed published literature and their own unpublished data.
Results:
The writing group unanimously supported the summary and recommendations as representing the working group's majority or unanimous opinions.
Conclusions:
The major questions linking obesity to type 2 diabetes that need to be addressed by combined basic, clinical, and population-based scientific approaches include the following: 1) Why do not all patients with obesity develop type 2 diabetes? 2) Through what mechanisms do obesity and insulin resistance contribute to β-cell decompensation, and if/when obesity prevention ensues, how much reduction in type 2 diabetes incidence will follow? 3) How does the duration of type 2 diabetes relate to the benefits of weight reduction by lifestyle, weight-loss drugs, and/or bariatric surgery on β-cell function and glycemia? 4) What is necessary for regulatory approval of medications and possibly surgical approaches for preventing type 2 diabetes in patients with obesity? Improved understanding of how obesity relates to type 2 diabetes may help advance effective and cost-effective interventions for both conditions, including more tailored therapy. To expedite this process, we recommend further investigation into the pathogenesis of these coexistent conditions and innovative approaches to their pharmacological and surgical management. |
doi_str_mv | 10.1210/jc.2011-0585 |
format | Article |
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Objective:
This report examines what is known about the relationship between obesity and type 2 diabetes and how future research in these areas might be directed to benefit prevention, interventions, and overall patient care.
Research Design and Methods:
An international working group of 32 experts in the pathophysiology, genetics, clinical trials, and clinical care of obesity and/or type 2 diabetes participated in a conference held on 6–7 January 2011 and cosponsored by The Endocrine Society, the American Diabetes Association, and the European Association for the Study of Diabetes. A writing group comprising eight participants subsequently prepared this summary and recommendations. Participants reviewed and discussed published literature and their own unpublished data.
Results:
The writing group unanimously supported the summary and recommendations as representing the working group's majority or unanimous opinions.
Conclusions:
The major questions linking obesity to type 2 diabetes that need to be addressed by combined basic, clinical, and population-based scientific approaches include the following: 1) Why do not all patients with obesity develop type 2 diabetes? 2) Through what mechanisms do obesity and insulin resistance contribute to β-cell decompensation, and if/when obesity prevention ensues, how much reduction in type 2 diabetes incidence will follow? 3) How does the duration of type 2 diabetes relate to the benefits of weight reduction by lifestyle, weight-loss drugs, and/or bariatric surgery on β-cell function and glycemia? 4) What is necessary for regulatory approval of medications and possibly surgical approaches for preventing type 2 diabetes in patients with obesity? Improved understanding of how obesity relates to type 2 diabetes may help advance effective and cost-effective interventions for both conditions, including more tailored therapy. To expedite this process, we recommend further investigation into the pathogenesis of these coexistent conditions and innovative approaches to their pharmacological and surgical management.</description><identifier>ISSN: 0021-972X</identifier><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2011-0585</identifier><identifier>PMID: 21602457</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Biological and medical sciences ; Diabetes ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - metabolism ; Diabetes Mellitus, Type 2 - therapy ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Feeding. Feeding behavior ; Fundamental and applied biological sciences. Psychology ; Genetics ; Humans ; Insulin resistance ; Lifestyle ; Medical sciences ; Nutrition ; Obesity ; Obesity - complications ; Obesity - metabolism ; Obesity - therapy ; Patients ; Preventive health ; Research (statistical design) ; Rodents ; Surgery ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology ; Weight Loss ; Writing</subject><ispartof>Diabetes care, 2011-06, Vol.96 (6), p.1654-1663</ispartof><rights>Copyright © 2011 by The Endocrine Society</rights><rights>2015 INIST-CNRS</rights><rights>Copyright American Diabetes Association Jun 2011</rights><rights>Copyright © 2011 by The Endocrine Society 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c560t-15116c1e5df8b2f8a92965b0d67bc9b3a808350ae0addb09ecdbfa00b94dcaf43</citedby><cites>FETCH-LOGICAL-c560t-15116c1e5df8b2f8a92965b0d67bc9b3a808350ae0addb09ecdbfa00b94dcaf43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,309,310,314,776,780,785,786,881,23909,23910,25118,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24203710$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21602457$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eckel, Robert H</creatorcontrib><creatorcontrib>Kahn, Steven E</creatorcontrib><creatorcontrib>Ferrannini, Ele</creatorcontrib><creatorcontrib>Goldfine, Allison B</creatorcontrib><creatorcontrib>Nathan, David M</creatorcontrib><creatorcontrib>Schwartz, Michael W</creatorcontrib><creatorcontrib>Smith, Robert J</creatorcontrib><creatorcontrib>Smith, Steven R</creatorcontrib><title>Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized?</title><title>Diabetes care</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Data show that the insights that improve obesity prevention and treatment will almost certainly benefit the incidence and care of type 2 diabetes.
Objective:
This report examines what is known about the relationship between obesity and type 2 diabetes and how future research in these areas might be directed to benefit prevention, interventions, and overall patient care.
Research Design and Methods:
An international working group of 32 experts in the pathophysiology, genetics, clinical trials, and clinical care of obesity and/or type 2 diabetes participated in a conference held on 6–7 January 2011 and cosponsored by The Endocrine Society, the American Diabetes Association, and the European Association for the Study of Diabetes. A writing group comprising eight participants subsequently prepared this summary and recommendations. Participants reviewed and discussed published literature and their own unpublished data.
Results:
The writing group unanimously supported the summary and recommendations as representing the working group's majority or unanimous opinions.
Conclusions:
The major questions linking obesity to type 2 diabetes that need to be addressed by combined basic, clinical, and population-based scientific approaches include the following: 1) Why do not all patients with obesity develop type 2 diabetes? 2) Through what mechanisms do obesity and insulin resistance contribute to β-cell decompensation, and if/when obesity prevention ensues, how much reduction in type 2 diabetes incidence will follow? 3) How does the duration of type 2 diabetes relate to the benefits of weight reduction by lifestyle, weight-loss drugs, and/or bariatric surgery on β-cell function and glycemia? 4) What is necessary for regulatory approval of medications and possibly surgical approaches for preventing type 2 diabetes in patients with obesity? Improved understanding of how obesity relates to type 2 diabetes may help advance effective and cost-effective interventions for both conditions, including more tailored therapy. To expedite this process, we recommend further investigation into the pathogenesis of these coexistent conditions and innovative approaches to their pharmacological and surgical management.</description><subject>Biological and medical sciences</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - metabolism</subject><subject>Diabetes Mellitus, Type 2 - therapy</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Feeding. Feeding behavior</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Genetics</subject><subject>Humans</subject><subject>Insulin resistance</subject><subject>Lifestyle</subject><subject>Medical sciences</subject><subject>Nutrition</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - metabolism</subject><subject>Obesity - therapy</subject><subject>Patients</subject><subject>Preventive health</subject><subject>Research (statistical design)</subject><subject>Rodents</subject><subject>Surgery</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><subject>Weight Loss</subject><subject>Writing</subject><issn>0021-972X</issn><issn>0149-5992</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp90U1v1DAQBmALgehSuHFGERIqB1LGdhzbHKhg-apU0UtXcLP8MaFeZZ0lzlZafj1Jd2kBIU6WPI9mxn4JeUzhmDIKL5f-mAGlJQgl7pAZ1ZUoJdXyLpkBMFpqyb4ekAc5LwFoVQl-nxwwWgOrhJyRxbnDHIdtYVMoLrZrLFjxLlqHA-ZXxZdLOxRzm4q3WCxSbCKGa3h9_xkx5GLopuJpCvEqho1t4w8MJw_Jvca2GR_tz0Oy-PD-Yv6pPDv_eDp_c1Z6UcNQUkFp7SmK0CjHGmU107VwEGrpvHbcKlBcgEWwITjQ6INrLIDTVfC2qfgheb3ru964FQaPaehta9Z9XNl-azobzZ-VFC_Nt-7KcAY113pscLRv0HffN5gHs4rZY9vahN0mG1UrLpWi06jn_5V0zIAByFqM9OlfdNlt-jR-hFGS80oqMaEXO-T7Lucem5utKZgpWLP0ZgrWTMGO_MnvL73Bv5IcwbM9sNnbtult8jHfuooBlxRGx3cOU-h8HxOue8z5dsV_jv8J4fK60Q</recordid><startdate>20110601</startdate><enddate>20110601</enddate><creator>Eckel, Robert H</creator><creator>Kahn, Steven E</creator><creator>Ferrannini, Ele</creator><creator>Goldfine, Allison B</creator><creator>Nathan, David M</creator><creator>Schwartz, Michael W</creator><creator>Smith, Robert J</creator><creator>Smith, Steven R</creator><general>Endocrine Society</general><general>American Diabetes Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0K</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7TS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20110601</creationdate><title>Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized?</title><author>Eckel, Robert H ; Kahn, Steven E ; Ferrannini, Ele ; Goldfine, Allison B ; Nathan, David M ; Schwartz, Michael W ; Smith, Robert J ; Smith, Steven R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c560t-15116c1e5df8b2f8a92965b0d67bc9b3a808350ae0addb09ecdbfa00b94dcaf43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Biological and medical sciences</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - metabolism</topic><topic>Diabetes Mellitus, Type 2 - therapy</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Feeding. Feeding behavior</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Genetics</topic><topic>Humans</topic><topic>Insulin resistance</topic><topic>Lifestyle</topic><topic>Medical sciences</topic><topic>Nutrition</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Obesity - metabolism</topic><topic>Obesity - therapy</topic><topic>Patients</topic><topic>Preventive health</topic><topic>Research (statistical design)</topic><topic>Rodents</topic><topic>Surgery</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><topic>Weight Loss</topic><topic>Writing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eckel, Robert H</creatorcontrib><creatorcontrib>Kahn, Steven E</creatorcontrib><creatorcontrib>Ferrannini, Ele</creatorcontrib><creatorcontrib>Goldfine, Allison B</creatorcontrib><creatorcontrib>Nathan, David M</creatorcontrib><creatorcontrib>Schwartz, Michael W</creatorcontrib><creatorcontrib>Smith, Robert J</creatorcontrib><creatorcontrib>Smith, Steven R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Agricultural Science Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>Physical Education Index</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eckel, Robert H</au><au>Kahn, Steven E</au><au>Ferrannini, Ele</au><au>Goldfine, Allison B</au><au>Nathan, David M</au><au>Schwartz, Michael W</au><au>Smith, Robert J</au><au>Smith, Steven R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized?</atitle><jtitle>Diabetes care</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2011-06-01</date><risdate>2011</risdate><volume>96</volume><issue>6</issue><spage>1654</spage><epage>1663</epage><pages>1654-1663</pages><issn>0021-972X</issn><issn>0149-5992</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>Data show that the insights that improve obesity prevention and treatment will almost certainly benefit the incidence and care of type 2 diabetes.
Objective:
This report examines what is known about the relationship between obesity and type 2 diabetes and how future research in these areas might be directed to benefit prevention, interventions, and overall patient care.
Research Design and Methods:
An international working group of 32 experts in the pathophysiology, genetics, clinical trials, and clinical care of obesity and/or type 2 diabetes participated in a conference held on 6–7 January 2011 and cosponsored by The Endocrine Society, the American Diabetes Association, and the European Association for the Study of Diabetes. A writing group comprising eight participants subsequently prepared this summary and recommendations. Participants reviewed and discussed published literature and their own unpublished data.
Results:
The writing group unanimously supported the summary and recommendations as representing the working group's majority or unanimous opinions.
Conclusions:
The major questions linking obesity to type 2 diabetes that need to be addressed by combined basic, clinical, and population-based scientific approaches include the following: 1) Why do not all patients with obesity develop type 2 diabetes? 2) Through what mechanisms do obesity and insulin resistance contribute to β-cell decompensation, and if/when obesity prevention ensues, how much reduction in type 2 diabetes incidence will follow? 3) How does the duration of type 2 diabetes relate to the benefits of weight reduction by lifestyle, weight-loss drugs, and/or bariatric surgery on β-cell function and glycemia? 4) What is necessary for regulatory approval of medications and possibly surgical approaches for preventing type 2 diabetes in patients with obesity? Improved understanding of how obesity relates to type 2 diabetes may help advance effective and cost-effective interventions for both conditions, including more tailored therapy. To expedite this process, we recommend further investigation into the pathogenesis of these coexistent conditions and innovative approaches to their pharmacological and surgical management.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>21602457</pmid><doi>10.1210/jc.2011-0585</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
subjects | Biological and medical sciences Diabetes Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - metabolism Diabetes Mellitus, Type 2 - therapy Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Feeding. Feeding behavior Fundamental and applied biological sciences. Psychology Genetics Humans Insulin resistance Lifestyle Medical sciences Nutrition Obesity Obesity - complications Obesity - metabolism Obesity - therapy Patients Preventive health Research (statistical design) Rodents Surgery Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology Weight Loss Writing |
title | Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized? |
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