Pharmacotherapy considerations in diabetes and obesity: setting patients up for success

The causal relationship between obesity and type 2 diabetes mellitus has been acknowledged over the past few decades and is frequently expressed by the term diabesity. It is predicted that the number of people with diabetes mellitus (DM) and prediabetes will continue to rise, with obesity placing people at increased risk for diabetic complications and comorbidities. Therefore, an individualized, patient-centered care approach is needed to optimally treat and manage the obese patient with DM. With 11 classes of medications available to lower blood glucose levels, 2 new agents for weight loss, and various surgical procedures, the clinician and the patient have numerous options from which to choose. In an effort to promote optimal disease management, clinicians should work with their obese patients to select appropriate pharmacotherapy combinations that will enable the patients to successfully manage DM. The current clinical recommendations and guidelines emphasize the need to consider the weight effects of the various DM agents as monotherapy and in combination. Additionally, with the approval of 2 new weight loss medications, the clinician must be aware of the place of the medications in therapy and their appropriate use in combination with DM pharmacotherapy.