Management of obesity in patients with type 2 diabetes mellitus in primary care.
OBJECTIVE
Obesity and being overweight is the most powerful risk factor accounting for 80-90% of patients with type 2 diabetes mellitus (T2DM). The epidemic of obesity is driving the diabetes epidemic to alarming levels and primary care is becoming an important setting for obesity management in T2DM in India. Yet many primary care providers feel ill-equipped or inadequately supported to address obesity in patients with diabetes. This article reviews the most recent and strongest evidence-based strategies that may aid physicians in management of obesity in patients with T2DM in primary care.


METHODS
A systematic literature search of MEDLINE using the search terms Obesity, Obesity in T2DM, weight loss and Primary Care was conducted. The American Diabetes Association, National Institute for Health, National Institute of Health and Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN) and World Health Organization websites were also searched. Most studies in this area are observational in design with few randomized controlled trials (RCTs). Articles and studies involving meta-analysis or RCTs were preferred over other types.


CONCLUSIONS
Effective weight management treatment in T2DM patient can be implemented in the primary care setting. Evidence based individualized lifestyle and pharmacologic measures supported by behavioral intervention and counseling with appropriate and informed surgical referrals has the potential to improve the success of weight management within primary care.
Alshifa Hospital, Delhi 110025, India. Electronic address: shoaibirfan@yahoo.co.uk.
Shoaib
S
Mohammad
Centre for Diabetes & Endocrinology, Faculty of Medicine, J. N. Medical College Hospital, A.M.U, Aligarh 202 002, India. Electronic address: jamalahmad11@rediffmail.com.
Jamal
J
Ahmad
D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D009765:Obesity / Q000150:complications / Q000628:therapy*; D064887:Observational Studies as Topic; D057285:Precision Medicine; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D061217:Weight Reduction Programs
Obesity; Obesity management; Primary care; Type 2 diabetes mellitus