Divide and Conquer: The Multidisciplinary Approach to Achieving Significant Long-Term Weight Loss and Improved Glycemic Control in Obese Patients With Type 2 Diabetes

Clinical Diabetes: Winter 2013

ype 2 diabetes has become a worldwide epidemic, estimated to affect 1 in 14 adults, or 380 million people, globally by 2025.^1,2 The problem is particularly acute in Australia, where the prevalence of diagnosed diabetes more than doubled between 1989 and 2005, amounting to 3 million people affected by the disease.^3,4 Diabetes is the most common reason for renal dialysis, blindness in people < 60 years of age, nontraumatic lower-limb amputation, and cardiovascular disease and is the sixth-highest cause of death by disease in Australia.^3,5

First-line best-practice management includes brief counseling to promote lifestyle changes in diet, exercise, and education, with the aim to improve insulin resistance, reduce hypertension, correct dyslipidemia, and achieve weight reduction.⁶ Patients at high risk of developing type 2 diabetes and who are refractory to lifestyle intervention may be treated with pharmacological agents and insulin, many of which contribute to further weight gain. Read More