New perspectives in the treatment of obesity in type 2 diabetics with cardiovascular diseases

Czech version

Authors: Martin Jozef Péč ¹; Jakub Jurica ¹; Anna Török Zapletalová ^1,2; Tomáš Bolek ¹; Matej Samoš ¹; Peter Galajda ¹; ; Marián Mokáň ¹
Authors‘ workplace: I. interná klinika JLF UK a UNM, Martin ¹; Diabetologické oddelenie NEDÚ, n. o., Ľubochňa ²
Published in: Forum Diab 2025; 14(2): 101-106
Category: Review Article

Overview

Obesity is a common comorbidity in patients with type 2 diabetes mellitus, significantly worsening metabolic compensation and cardiovascular prognosis. Modern antidiabetic drugs aimed at weight reduction –⁠ especially GLP-1 receptor agonists (semaglutide, liraglutide), dual GIP/GLP-1 agonists (tirzepatide), and SGLT2 inhibitors (empagliflozin, dapagliflozin) –⁠ have brought new possibilities for the effective treatment of obesity in diabetics. In clinical studies, these drugs have demonstrated significant weight loss, improved diabetes mellitus compensation (decrease in HbA_1c), and reduced cardiovascular risk (decrease in the incidence of myocardial infarction, stroke, and cardiovascular mortality). This article provides an overview of the pathophysiological basis of obesity in diabetes, current treatment approaches, and the latest findings from clinical studies. We emphasize the dominant position of new incretin drugs in the treatment of obesity in diabetics and their place in current recommendations. Combination therapy (e.g., combining a GLP-1 receptor agonist with an SGLT2 inhibitor) may also have a synergistic effect on weight loss, glycemic control, and cardiovascular benefits. These new approaches represent a fundamental shift in the management of patients with type 2 diabetes mellitus and cardiovascular disease.

Keywords:

GLP1 receptor agonists – weight – diabetes mellitus – dual GIP/GLP-1 agonist – incretins – inhibitors SGLT2 –obesity

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