Glucocentricity or adipocentricity: A critical view of consensus and clinical guidelines for the treatment of type 2 diabetes mellitus
| Autor: | Juan José Gorgojo Martínez |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Blood Glucose
medicine.medical_specialty endocrine system diseases business.industry nutritional and metabolic diseases Type 2 Diabetes Mellitus Overweight medicine.disease Obesity Surgery chemistry.chemical_compound Diabetes Mellitus Type 2 chemistry Weight loss Intervention (counseling) medicine Humans Glycated hemoglobin medicine.symptom Intensive care medicine business Weight gain Algorithms Glycemic |
| Zdroj: | Endocrinología y Nutrición (English Edition). 58:541-549 |
| ISSN: | 2173-5093 |
| Popis: | Eighty percent of patients with type 2 diabetes mellitus (T2DM) are overweight or obese, which in turn is associated with other cardiovascular risk factors and an increased risk of cancer. Large intervention studies that focused on intensive glycemic control have failed to show a reduction of cardiovascular events in T2DM patients. The two major concerns in these studies were weight gain and severe hypoglycemia in the arms of intensive intervention, which could have mitigated the potential beneficial effect of glycemic control. On the contrary, weight loss in diabetic patients through changes in lifestyle, drugs and/or surgery simultaneously improves all cardiovascular risk factors including hyperglycemia. Bariatric surgery has shown an early resolution of T2DM in a large percentage of patients and a decrease of diabetes-specific mortality. Despite this, all consensus and recommendations for the treatment of T2DM focus their decisions on the glycated hemoglobin value. This article aims to open a debate on the need to replace the glucose-centered therapeutic strategy for a weight-centered strategy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect