Achieving Effective Weight Loss for Type 2 Diabetes Mellitus Control: From Evidence to Practice

Abstract

Type 2 diabetes mellitus (T2DM) poses a significant public health concern in Singapore. It is well established that T2DM is strongly associated with obesity. In Singapore, the prevalence of obesity and overweight in adults has been increasing over the last two decades. By 2050, the prevalence of obesity in the nation is predicted to reach 15.9 percent, a rise from 4.3 percent in 1990. The total prevalence of T2DM is also projected to rise to 15 percent in 2050, which was 7.3 percent in 1990, in tandem with the rise in obesity prevalence. Moderate and sustained weight loss (5-10 percent) improves glycaemic control and cardiovascular risk factors in overweight or obese patients with T2DM. Disease-modifying effects in T2DM and improvement in long-term cardiovascular outcomes and mortality are associated with larger and sustained weight losses (>10 percent). In this article, we highlight the growing burden of T2DM and its complications in Singapore and the role of weight loss in T2DM control. This article aims to provide an overview of multidisciplinary/multipronged strategies (lifestyle interventions, patient-centred approach with preferential use of glucose-lowering medications of weight neutral/weight loss effect, consideration of pharmacotherapy for weight loss and metabolic surgery) to achieve effective weight loss for T2DM control.