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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Veröffentlicht in:Diabetes care 2011-06, Vol.96 (6), p.1654-1663
Hauptverfasser: Eckel, Robert H, Kahn, Steven E, Ferrannini, Ele, Goldfine, Allison B, Nathan, David M, Schwartz, Michael W, Smith, Robert J, Smith, Steven R
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container_end_page 1663
container_issue 6
container_start_page 1654
container_title Diabetes care
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creator Eckel, Robert H
Kahn, Steven E
Ferrannini, Ele
Goldfine, Allison B
Nathan, David M
Schwartz, Michael W
Smith, Robert J
Smith, Steven R
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 Participants reviewed and discussed published literature and their own unpublished data.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.
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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. 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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. 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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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