COMMENTARY

What Is the Weight Impact of Type 2 Diabetes Treatment?

Priya Sumithran, PhD; Mark Harmel, MPH, CDCES

Disclosures

August 01, 2022

This transcript has been edited for clarity.

Diabetes treatment is currently focused on lowering blood glucose to reduce the risk for complications, particularly microvascular complications. Treatment approaches are also available to reduce the cardiovascular disease risk in people who are at high risk for or with established cardiovascular or kidney disease.

Not everyone with type 2 diabetes has obesity, but most people with type 2 diabetes do have abnormally functioning fat cells or unhealthy fat. That's what drives the metabolic process that results in diabetes.

People whose diabetes is primarily driven by unhealthy fat would benefit from prioritizing weight management in the treatment of their diabetes. That means not only using medications that control the blood glucose but also thinking about which medications might help with weight management and what other interventions might help with weight management, such as lifestyle interventions, changes in diet, changes in physical activity, and prioritizing medications that are going to both treat their diabetes and help them reduce weight.

We need to think about this in the majority of our patients with diabetes because most of them, even if they don't have obesity (as defined by a body mass index above 30), will have their unhealthy adipose tissue contribute to the disease process.

Over the past few years, it's become much easier to treat people with diabetes and excess weight with medications that are becoming increasingly available and increasingly effective at managing weight, diabetes, and other aspects of metabolic health.

We need to consider the weight impact of the treatment program that we use in our patients with diabetes and we should prioritize helping them with their weight management and focusing on treating diabetes.

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