In times of the COVID-19 crisis and the associated lockdowns, recent studies have shown that these lifestyle changes lead to reduced exercise, unhealthy diet and stress. This, in turn, leads to overweight or obesity. In patients with diabetes, this can also lead to deterioration in blood sugar profiles or even blood sugar derailment. The risks for micro- and macrovascular diseases such as retinopathy, neuropathy, kidney disease and cardiovascular diseases also increase.
The support and care of diabetes patients is now all the more important. Individuals have to be motivated to exercise, eat healthy, and manage stress in a healthy way. Blood sugar settings and doses must also be checked more regularly as a result of this interruption to our routines.
Much research demonstrates that lifestyle changes are the most important measure for treating overweight and obesity. In Type 2 Diabetics with obesity, there is an additional option of drug therapy which may at times be required.
Obesity, Diabetes, and Medications
Metformin is a common first-line therapy choice for most Type 2 Diabetics. After therapy with Metformin in Type 2 Diabetics with obesity, the ADA guidelines recommend the use of a GLP1 agonist or a SGLT2 inhibitor as a second line therapy.
The GLP1 agonists show the most effective weight loss, at 3-10 kg between 6 to 12 months of monotherapy. Their positive impact on beta cell insulin production and inhibition of glucagon secretion from alpha cells means that less glucose is built up in the body. GLP1 agonists also have extra-pancreatic effects such as slowing of gastric emptying and increased satiety, all of which contribute to improved glycaemia and weight loss – both attractive outcomes for those with Type 2 Diabetes and obesity.
If there is a contraindication for GLP1 agonist, or its already in the care plan, a SGLT2 inhibitor can be used as third line therapy. These show an average weight loss of 1-3kg in 6 to 12 months (as monotherapy). SGLT2 inhibitors are glucose-lowering drugs that reduce plasma glucose levels by inhibiting glucose and sodium reabsorption in the kidneys, thus resulting in glucosuria.
Obesity, Diabetes, and GluCare
The COVID-19 crisis has changed the world and also our lifestyle.
Overweight/Obesity, unhealthy diet and stress is unfortunately rising in these times. This can lead to serious complications, especially in diabetes patients.
We, your GluCare Team, accompany our patients on sufficient exercise, a healthy diet and good blood sugar control. Additionally, the new generation of diabetes medications we provide can not only help you to have good blood sugar control but also to lose significant weight. The 24/7 remote patient care, a cornerstone of the GluCare program, monitors your vital aspects and keeps collecting and analyzing your health data, even in times of lockdown.
GluCare Integrated Diabetes Center provides ideal remote healthcare to help those with diabetes, obesity, and more, especially during these uncertain times.
Coronavirus: the Paradox between Food Insecurity and Weight Gain, Faiza Nouh, Salima Elfagi & Mariam Omar, EAS Journal of Nutrition and Food Sciences, 04.2020
Effects of COVID‐19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study, Angelo Pietrobelli Luca Pecoraro Alessandro Ferruzzi Moonseong Heo Myles Faith Thomas Zoller Franco Antoniazzi Giorgio Piacentini S. Nicole Fearnbach Steven B. Heymsfield, 04.2020
ADA, Standards of Medical Care in Diabetes—2020
Emerging Role of SGLT-2 Inhibitors for the Treatment of Obesity, Maria J. Pereira & Jan W. Eriksson, Drugs, 2019
About the Author
Dr. Yousef Said is a German Board-Certified Specialist in Internal Medicine and Diabetology at GluCare. He graduated from the University of Cologne Medical School, Germany, and has a special interest in the diagnostic and treatment of Diabetic Foot Syndrome.