Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized? Article

International Collaboration

cited authors

  • Eckel, Robert H., Kahn, Steven E., Ferrannini, Ele, Goldfine, Allison B., Nathan, David M., Schwartz, Michael W., Smith, Robert J., Smith, Steven R.

funding text

  • This article is based on a conference jointly sponsored by The Endocrine Society, the American Diabetes Association, and the European Association for the Study of Diabetes, with the financial support of an unrestricted educational grant from Novo Nordisk. R.H.E. received grant/research support from Sanofi Research Grant (fellowship educational grant), dia-Dexus, and GlaxoSmithKline; compensation for working as a consultant for Amylin, GTC Nutrition, Genfit, Eli Lilly, Pfizer, Johnson&Johnson, and Esperion; financial or material support from Cardiometabolic Health Congress and Metabolic Syndrome Institute; and honoraria from Vindico, CME Incite, and Voxmedia. S. E. K. received consulting fees from Eli Lilly, GlaxoSmithKline, Intarcia Therapeutics, and Novo Nordisk for acting as an advisory board member; consulting fees and honoraria from Boehringer Ingelheim and Merck for acting as an advisory board member and speaker; and grant support from Daiichi Sankyo. E. F. received consulting fees from Merck, Boehringer Ingelheim, Bristol-Myers Squibb/AstraZeneca, sanofi-aventis, Novartis, GlaxoSmithKline, and Daiichi Sankyo and grant support from Merck and Eli Lilly. A. B. G. acted as Site Principal Investigator for a clinical trial funded by Eli Lilly that is now complete with results published. M. W. S. received consulting fees from Merck, Pfizer, and Orexigen. R.J.S. received consulting fees from GI Dynamics and royalties from Baxter and Fresenius Kabi. S. R. S. received consulting fees from Amylin, Bristol-Myers Squibb, Eli Lilly, and Novartis and consulting fees as an advisory board member for Arena. No other potential conflicts of interest relevant to this article were reported.

abstract

  • 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 beta-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 beta-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. ( J Clin Endocrinol Metab 96: 1654-1663, 2011)

authors

Publication Date

  • June 1, 2011

webpage

published in

category

start page

  • 1654

end page

  • 1663

volume

  • 96

issue

  • 6

WoS Citations

  • 136
  • 142

WoS References

  • 50