Slide 1

Management of Common Comorbidities in Diabetes 1

Slide 2

Slide 3

Slide 4

Obesity 4

Slide 5

Prevalence of Obesity in Type 2 Diabetes 5 63% 24% 13% Normal (BMI

Abdominal Obesity and Increased Risk of Cardiovascular Events Dagenais GR, et al. Am Heart J. 2005;149:54-60. Waist Circumference (cm) MenWomen Tertile 198 The HOPE Study *Adjusted for BMI, age, smoking, sex, CVD disease, DM, HDL-cholesterol, total-C; CVD: cardiovascular disease; MI: myocardial infarction; BMI: body mass index; DM: diabetes mellitus; HDL: high-density lipoprotein cholesterol. 10

Slide 11

Pulmonary disease Abnormal function Obstructive sleep apnea Hypoventilation syndrome Nonalcoholic fatty liver disease Steatohepatitis Cirrhosis Coronary heart disease Diabetes Dyslipidemia Hypertension Gynecologic abnormalities Abnormal menses Infertility Polycystic ovary syndrome (PCOS) Osteoarthritis Skin Gall bladder disease Cancer Breast, uterus, cervix, colon, esophagus, kidney, pancreas, prostate Phlebitis Venous stasis Gout Idiopathic intracranial hypertension Stroke Cataracts Severe pancreatitis Medical Complications of Obesity 11

Slide 12

Weight loss Every kg of weight loss is associated with 3-4 months of improved survival 1 In a prospective analysis of 5000 people with type 2 diabetes, 35% reported intentional weight loss; this subgroup experienced a 25% reduction in mortality over 12 years 2 Weight gain A 5-kg weight gain increases CHD risk by 30% 3 Health Effects of Weight Change in T2DM 12 1. Lean ME, et al. Diabet Med. 1990;7:228-233. 2. Williamson DF, et al. Diabetes Care. 2000;23:1499-1503. 3. Anderson JW, et al. J Am Coll Nutr. 2003;22:331-339.

Slide 13

13 Intensive Intervention Reduces Significantly More Weight than Standard Approaches in T2DM Differences between groups were statistically significant (P 0.0001) at all 4 years. ILI, intensive lifestyle intervention; DSE, diabetes support and education. Look AHEAD Research Group. Arch Intern Med. 2010;170:1566-1575. Reduction in initial weight (%) -2 -10 Years 0 -4 -6 -8 01 2 3 4 Retention at 4 years: ILI = 94.1% DSE = 93.1% -1.1% -4.7% P