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ECO 2024: Is Diabetes an Adiposity Based Disease?

6th June 2024

While obesity is regarded a major risk factor for the development of type 2 diabetes, the causality of the association remains debated. With current therapies targeting both obesity and diabetes, the exchange between specialists is becoming increasingly important. In the following video, EASD Board member Tina Vilsbøll shares insights from the Joint EASD/EASO Session at the European Congress on Obesity (ECO) 2024.

Diabetes and obesity are among the most pressing public health challenges of our time, and their prevalence is increasing worldwide. At the same time, scientific knowledge and treatment options are also advancing. Lifestyle interventions, pharmacological treatments and bariatric surgery offer benefits for both conditions. However, the interplay between diabetes and obesity continues to be an area of ongoing research. The question “Is Diabetes an Adiposity Based Disease?” was the focus of a Joint Session of the European Association for the Study of Obesity (EASO) and the European Association for the Study of Diabetes (EASD) at the ECO Congress 2024 in May in Venice, Italy.

EASD/EASO Joint Session highlights

“Diabetes and obesity are very closely related,” says Professor Tina Vilsbøll, Honorary Secretary of EASD and session co-chair, reflecting on the congress. She stresses that obesity, diabetes as well as cardiovascular disease and other comorbidities are linked not only scientifically, but also clinically.

The Joint Session began with insights from the Diabetes Remission Clinical Trial (DiRECT), which investigated the effects of lifestyle interventions on weight loss and diabetes remission in primary care centres in the UK. Recently, a 5-year follow-up of DiRECT outcomes has been published in The Lancet Diabetes & Endocrinology, further suggesting that sustained weight loss is associated with better glycaemic control and improved health status.

The benefits of bariatric surgery for diabetes remission were discussed, before Vilsbøll gave an update on incretin-based approaches. “We have a lot of evidence with respect to GLP-1 based therapy, especially for the treatment of type 2 diabetes, but in recent years also for obesity,” says Vilsbøll and concludes that a lot of the diabetes prevention seen with anti obesity treatment “is actually on the shoulders of GLP-1.”

“The future is crazy!”

In addition to the incretin-based therapies already available to clinicians, Tina Vilsbøll listed 16 different peptides currently in phase 2 or phase 3 development, and additionally up to 40 compounds developed by almost 20 different companies for the future treatment of obesity and type 2 diabetes.

“Many specialists, from cardiologists to nephrologists and increasingly hepatologists, are now interested in GLP-1- and incretin-based therapies, the latter group in the context of metabolic dysfunction-associated fatty liver disease (MAFLD),” says Vilsbøll, underlining the broad clinical relevance of this treatment approach, not only for people living with type 2 diabetes but also for obesity and commonly associated comorbidities.

Joining forces to take an interdisciplinary approach

Recognising the role of adiposity in diabetes underlines the importance of weight management in both the prevention and management of diabetes. However, it is important to acknowledge that not all individuals with obesity develop diabetes and that not all individuals with diabetes have adiposity. The collaboration between EASO and EASD fosters an interdisciplinary approach to understanding and addressing these interrelated health challenges, which will be pivotal in the future, “because obesity, diabetes, cardiovascular disease and a lot of other comorbidities really go hand in hand,” emphasises Tina Vilsbøll.

EASD/EASO Joint Session ”Is Diabetes an Adiposity Based Disease?” :
Chairs: Tina Vilsbøll (Denmark), Paolo Sbraccia (Italy)
  • Roy Taylor (UK): What we learned from the DiRECT trial?
  • Barbara McGowan (UK): Bariatric Surgery and Diabetes Remission?
  • Tina Vilsbøll (Denmark): Is there a role for the new generation AOM for preventing diabetes?
  • Mikael Ryden (Sweden): Moving from beta-cell to brain to treat diabesity

To learn more about the EASO, go to:

Author: Hanna Gabriel, BA MSc. Any opinions expressed in this article are the responsibility of EASD e-Learning.