Weight-management medications and 
patients with type 2 diabetes


In patients with type 2 diabetes, weight-management medications are associated with an improvement in blood glucose and a reduction in the number of diabetes medications. Because sulfonylureas, thiazolidinediones (TZDs), and meglitinides can cause weight gain, removing the sulfonylurea may facilitate weight loss.43,44


Behavioral therapy


Appropriate nutrition and routine increases in physical activity are critical. Behavior modification is similarly important. Thus, the best chance for success of any weight-management program is with a multidisciplinary team approach involving clinicians, dietitians, physical-activity/exercise specialists, and other clinicians specifically trained in the care of patients who are overweight or obese.45


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Continuation of case study


John’s current physical activity and readiness to begin a physical-activity regimen should be evaluated in order to create an individualized physical-activity plan. Physical-activity goals should be appropriate for his current physical-fitness level, lifestyle, and personal preferences.8

Referral to other health-care professionals, including a dietitian, nurse educator, physical-activity professional, and mental-health professional, may be useful for this patient.8He may also benefit from the use of web-based programs and mobile applications.

John will continue to be monitored for changes in body weight, blood glucose, blood pressure, and lipids.43Changes in the number and dose of medications may be required. Change in weight should be evaluated and medications should be modified at week 12, if indicated (Table 2). The patient should also continue to be monitored for adherence to the individualized behavioral therapy plan, and his physical-activity goals should be adjusted as needed.