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Weight loss is identified as a new priority in the treatment of Type 2 Diabetes by International Societies

The proposal should also reach Brazil, which celebrates the National Diabetes Day on June 26.

Weight loss is identified as a new priority in the treatment of Type 2 Diabetes by International Societies
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Weight loss is being identified worldwide as one of the main steps to prevent the progression of Type 2 Diabetes and ensure glycemic control. The information began to be released at the beginning of June, during the 82nd Scientific Sessions of the American Diabetes Association, made in the United StatesWhere the American and European Diabetes Societies proposed a new algorithm, oriented that the treatment of obesity is the initial step for the treatment of type 2 diabetes and, consequently, to reduce the glycemic indexes.

A new algorithm means reviewing the guidelines that will guide the treatment of a disease, especially chronic diseases such as type 2 diabetes. The algorithms – published annually by the American Diabetes Society – regulate from treatment in the offices and even the review of public policies for the treatment of type 2 diabetes in the country. This includes the step-by-step care, as will the infrastructure and the order of conduct, whether clinical or surgical.

The proposal should also reach Brazil, which celebrates the National Diabetes Day on June 26.

“The new guidelines are reviewed and published annually by the American Society and, for sure, they will serve as a key point for the publication of the new Brazilian guidelines soon”, explains endocrinologist André Vianna, who is also coordinator of the Society’s education department. Brazilian Society of Diabetes (SBD).

According to him, it was always known that obesity was the fundamental factor, as well as the most challenging task for a person with type 2 diabetes. “However, this factor is only now being put in the first place”, highlighted the endocrinologist.

Scientific basis – The change proposed by the American and European Diabetes Societies, based on a scientific study, published in September 2021, in The Lancet, an important international journal, showed that in those patients with diabetes associated with obesity, weight loss is the first step to control blood glucose and to prevent the progression of the disease and its complications, such as renal failure and cardiovascular events, such as myocardial infarction and stroke. The new pharmacological agents, despite still having studies with a short follow-up time, have excellent results in relation to weight loss and glycemic control. However, as with any medical treatment, there are patients who do not have the expected response to drug treatment. Thus, for those where the best treatment fails to achieve the goal, metabolic surgery features prominently in the proposed new algorithm.

The Lancet article featured Dr. Ricardo Cohen, Coordinator of the Specialized Center for Obesity and Diabetes at Hospital Alemão Oswaldo Cruz, in addition to researchers from the USA, Australia and Ireland. “This is the first time that weight loss is mentioned as an initial step in the treatment of type 2 diabetes so that there is a reduction in blood glucose afterwards, that is, weight loss was pointed out as the main tool to stop the evolution of the disease in the long term. ”, says Dr. Ricardo Cohen, coordinator of the Specialized Center for Obesity and Diabetes at Hospital Alemão Oswaldo Cruz and one of the authors of the publication.

Data – Recently, the International Diabetes Federation (IFD) published the 10th edition of the Atlas of Diabetes. The data show the growth of the disease and place Brazil in the ranking among the countries with the highest prevalence and treatment expenses.

This year, the estimated cost of diabetes in Brazil is US$42.9 billion, second only to China and the United States, with US$ 165.3 billion and US$ 379.5 billion, respectively. According to the report, Brazil is the sixth country in the world with the highest number of patients with diabetes. There are about 15.7 million people living with the disease. By 2045, the estimate is that we will have around 23.2 million patients in the country. Because it is a disease that has no symptoms in its early stages, diabetes is difficult to diagnose. The new edition of the Atlas estimates that in Brazil alone about 5 million people do not know they have diabetes.

Overweight and obesity are risk factors

It is estimated that 90% of diabetes cases in the world are Type 2. Despite genetics having a strong influence on the development of the disease, overweight and obesity are the main reasons for the growth of this type of diabetes in the world. Treatment for type 2 diabetes includes medical treatment, lifestyle changes, physical exercise and the introduction of a proper diet. Patients with a BMI over 30 who are not getting results with lifestyle changes and medications may be indicated for metabolic surgery.

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