The major questions linking obesity to type 2 diabetes that need to be
addressed by combined basic, clinical, and population-based scientific approaches include the
following: 1) Why do not all patients with obesity develop type 2 diabetes? 2) Through what
mechanisms do obesity and insulin resistance contribute to b-cell decompensation, and if/when
obesity prevention ensues, how much reduction in type 2 diabetes incidence will follow? 3) How
does the duration of type 2 diabetes relate to the benefits of weight reduction by lifestyle, weight-loss
drugs, and/or bariatric surgery on b-cell function and glycemia? 4)What is necessary for regulatory
approval of medications and possibly surgical approaches for preventing type 2 diabetes in patients
with obesity? Improved understanding of how obesity relates to type 2 diabetes may help advance
effective and cost-effective interventions for both conditions, including more tailored therapy. To
expedite this process, we recommend further investigation into the pathogenesis of these coexistent
conditions and innovative approaches to their pharmacological and surgical management.
The major questions linking obesity to type 2 diabetes that need to beaddressed by combined basic, clinical, and population-based scientific approaches include thefollowing: 1) Why do not all patients with obesity develop type 2 diabetes? 2) Through whatmechanisms do obesity and insulin resistance contribute to b-cell decompensation, and if/whenobesity prevention ensues, how much reduction in type 2 diabetes incidence will follow? 3) Howdoes the duration of type 2 diabetes relate to the benefits of weight reduction by lifestyle, weight-lossdrugs, and/or bariatric surgery on b-cell function and glycemia? 4)What is necessary for regulatoryapproval of medications and possibly surgical approaches for preventing type 2 diabetes in patientswith obesity? Improved understanding of how obesity relates to type 2 diabetes may help advanceeffective and cost-effective interventions for both conditions, including more tailored therapy. Toexpedite this process, we recommend further investigation into the pathogenesis of these coexistentconditions and innovative approaches to their pharmacological and surgical management.
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