Physicians recommend a variety of treatments for diabetes and obesity. Among those are dietary and behavioral modifications, hypoglycemic (oral and / or injected) drugs, bariatric surgery, or a combination of the above. These approaches have varying degrees of success and each has its own advantages and shortcomings.
Several life style factors such as bad nutrition, “emotional eating” and physical inactivity affect the incidence of diabesity. In order to achieve results by life style modifications, patients must be motivated to lose weight.
A typical program will usually include a special diet and exercise in order to promote weight loss. It is very hard to lose 10% of your body weight by diet alone, and an even bigger challenge to maintain the weight loss once achieved. As a result, dietary programs are often complemented by physical activity regimens, designed to maintain the new weight.
It is important to mention that treating obesity in patients with diabetes is particularly challenging because it is more difficult for diabetics to lose weight than it is for non-diabetics.
When people with Type 2 Diabetes are unable to control blood sugar sufficiently with diet and exercise, medication is usually prescribed. There are numerous classes of diabetes pills available, and they are often used in combination. Some medications work by stimulating the pancreas to make more insulin, and others improve the effectiveness of insulin, or block the digestion of starches.
Injected anti-diabetes agents
Injected anti-diabetes medications – such as insulin and the recently approved category of GLP-1 receptor agonists – involve daily injections and are also associated with various side effects in addition to their desired effect.
More on GLP-1 receptor agonists
Insulin therapy — by injections or by an insulin pump —may also be prescribed in combination with pills for more advanced disease cases. Insulin with or without oral medications has been shown to improve glycemic control However, insulin carries with it a risk of hypoglycemia (which may lead to fainting), weight gain which can eventually exacerbate the diabetes, as well as increase risk of cardiovascular complications.
Many diabetics find that managing their disease can be difficult. The biggest problem areas for diabetes patients appear to be getting the recommended levels of exercise and following their diet and meal plan. Adherence to medical therapy also proves to be problematic, as patients often find it difficult to manage a treatment regime of numerous pills each day as well as receive frequent injections. Medication side effects such as nausea weight gain and risk of hypoglycemia make treatment adherence even more difficult.
Diabetic patients using insulin or other drugs that cause weight gain, enter a vicious cycle, resulting in an escalating drug dose and an increasing challenge to properly control glycemic status. Currently available weight loss drugs typically fall short of achieving sufficient weight reduction to revert obesity, while their side effects can be significant.
Despite availability of several classes of pharmacological anti-diabetic agents there is still a clear unmet need for a safe treatment that would comprehensively address the entire metabolic syndrome and will bring about weight loss with minimal requirement for patient compliance.