Treatment and clinical management strategies for overweight and obesity

EXECUTIVE SUMMARY

Diabetes presents an enormous challenge to Europe and to the 20 million sufferers in the enlarged European Union. (EURADIA). Looking forward, the number of patients with type 2 diabetes globally is estimated to increase from 246 million to 380 million by 2030, (International Diabetes Federation) and the associated cost of treatment and increased hospitalisation of this population puts immense strain on healthcare systems and providers. The United Nations' adoption of a resolution on diabetes in December 2006 - the first of its kind for a non-communicable disease- serves to highlight the global nature and impact of this metabolic disease.

Diabetes is associated with an increased risk of macrovascular disease: myocardial infarction, stroke and peripheral vascular disease. Alarmingly, the growing prevalence of diabetes has the potential to reverse the fall in heart disease being seen in the developed world and is likely to precipitate a major increase in cardiovascular disease in the developing world. Equally worrying, is the falling age at onset of type 2 diabetes, presenting itself amongst younger populations. The long-term complications (micro- and macro-vascular disease) of diabetes are occurring at younger ages. The main associations are obesity and physical inactivity.

The association between average weight of population groups and the prevalence of non-insulin-dependent diabetes has been repeatedly observed. The risk for diabetes has been reported to be about twofold in the mildly obese, fivefold in moderately obese and tenfold in severely obese persons. Statistically significant improvements have been observed in both diabetes and hypertension with 10 percent weight loss, and in cardiovascular conditions, with 5 percent weight loss.

With more than half of the UK adult population deemed overweight or obese and a significantly large proportion needing help with weight management, (NICE), the most cost-effective intervention is lifestyle modification. This has been shown to be effective in the US, China and India, preventing the development of diabetes in high-risk individuals – mostly those with ‘pre-diabetes’ – in experimental settings. In all cases more than 50% prevention or delay in onset was achieved. However, these were short-term studies whereas the need is for more long-term prevention. The current challenges lie applying lifestyle measures in ‘free-range’ individuals, and second, detecting those people at highest risk? Detection of individuals at high risk is also important. Age and family history of diabetes are important. Another very helpful preliminary screening test is measurement of waist circumference. Another outstanding question is whether drug therapy helps or should be used? Several studies have shown benefits of drugs such as metformin, acarbose and thiazolidenediones and weight-loss drugs may also play a part but not all high-risk individuals will actually develop the disorder and it is therefore imperative that such drugs have strong safety profiles.

Surgical intervention is increasingly playing a greater role in lasting treatment for morbid obesity through Bariatric surgery and increasing clinical evidence is being found to suggest that it has a significant role to play in the treatment of metabolic diseases and conditions including type 2 diabetes, hypertension, and high cholesterol.

In response, Sovereign Medical is producing the Metabolic Disease Review Europe for an audience of physicians and stakeholders including endocrinologists, endocrine surgeons, cardiologists, bariatricians, psychologists, dieticians and nurses. The report will discuss the growing prevalence of metabolic disease, in particular, type 2 diabetes. As well as examining treatment and clinical management strategies, the review will also discuss the role of metabolic surgery in preventing overweight and obesity.

The aim of the report is to assist clinicians and caregivers in reducing the burden of these conditions upon patients, their families and health systems as a whole, whilst simultaneously improving patient outcomes.

Purpose

The Metabolic Review is intended to provide an in-depth analysis and overview of the Metabolic Syndrome which is commonly associated with overweight, obesity, and diabetes mellitus type 2, (DM T2).

Currently available therapies are not effective enough to normalise glucose and lipid metabolism and thus prevent complications. The review will address urgent unmet needs and opportunities to improve diabetes therapy for approximately 20 million patients in Europe. Independent articles examining the clinical features, treatment and research into the cluster of related risk factors of cardiovascular disease and diabetes mellitus type 2 characterised by central adiposity (abdominal obesity), abnormal blood lipid levels, high blood pressure and glucose intolerance are written and presented by leading experts in Europe.

PROPOSED TOPICS

• Abdominal obesity
• abnormal blood lipid levels
• high blood pressure
• glucose intolerance.

THOUGHT LEADER COLLABORATION

European Metabolic Review draws on the expertise of key opinion leaders within the endocrine, diabetes, and obesity sectors to ensure that it delivers world-class insights into the key developments and advancements within this vital clinical area.

Thought leaders and organisations that are being invited to contribute to the publication include:

ADVISORY PANEL

• Professor Philip James, Chair of the International Obesity Taskforce and Senior Vice President of the International Association for the Study of Obesity
• Russell Viner, Consultant/ Honorary Senior Lecturer in Adolescent Medicine and Endocrinology, University College London Hospitals and Great Ormond St Hospital
• Professor James McEwen, Emeritus Professor in Public Health and Honorary Senior Research Fellow, University of Glasgow
• Mr Tam Fry, Honorary Chair, Child Growth Foundation
• Dr Louis Levy, Branch Head, Nutrition Policy and Advice, Food Standards Agency

EDITORIAL CONTRIBUTORS

• Peter M Nilsson, MD, PhD, Professor of Clinical Cardiovascular Research University Hospital Malmö Sweden
• Professor Paul Valensi, Department of Endocrinology- Diabetology- Nutrition, Jean-Verdier Hospital, AP-HP, Paris-Nord University, France
• Valdis Pirags MD, Professor of Medicine, University of Latvia, Head of the Clinic of Internal Medicine at the Paul’s Stradins Clinical University Hospital in Riga
• Lars Sjorstrom MD, PhD SOS Secretariat, Sahlgrenska University Hospital, Goteberg, Sweden
• Gaetano Crepaldi University of Padua, Aging Section, University of Padua, Italy
• Manuel Puig-Domingo, Professor of Endocrinology, Hospital Clinic, Barcelona, Spai
• Martin Kuhlmann, Professor of Medicine and Nephrology at the Vivantes-Klinikum im Friedrichshain, Germany
• Michel Marre, Professor of Endocrinology and Metabolism at the Xavier-Bichat Faculty of Medicine, University of Paris VII and Head of Diabetes in the Endocrinology and Nutrition Department at the Hôpital Bichat in Paris, France
• Rafael Carmena, Professor of Internal Medicine and Endocrinology, University of Valencia, Spain
• Jochen Seufert, Professor of Internal Medicine, Endocrinology and Diabetology, University of Freiburg, Germany

All content will be independent and unbiased and submitted as original papers and review articles by the authors.

Sovereign Publications is committed to the observance of the regulations that govern the promotion of medicines and the support of scientific and educational material and as such, Sovereign requests support from companies; companies never approach us. We assure that the content will be educational and non-promotional in nature, and will be planned, designed and implemented in accordance with American and European Codes of Practice (FDA, ABPI, IFPMA, and EFPI). Authors are not paid and are commissioned by Sovereign and there is no scientific bias in the content published. Support from your company will be clearly and prominently disclosed. Financial support of Sovereign content is never perceived as an inducement to healthcare professionals to prescribe or recommend a particular medicine or course of treatment.

SUPPORTING ORGANISATIONS

• International Diabetes Federation (IDF)
• International Diabetes Federation (IDF)
• European Society of Endocrinology (ESE)
• The European Association for the Study of Obesity (EASO)
• European Society of Hypertension (ESH)

CIRCULATION & READERSHIP

The success of the report can be measured in the scope and depth of the publications readership which spans medical doctors, consultants and surgeons in primary and secondary care settings ranging from general practice to large general hospitals and centres of excellence, including:

• Endocrinologists
• Cardiologists
• nephrologists
• diabetes educators

• Print and electronic distribution by name to clinicians
• e-book version emailed out to clinicians and available on the Metabolic Review Europe website from March 2009
• Search engine optimized articles available online and free of charge
• Copies will be distributed at key professional meetings throughout 2009.

Distribution by Country

• Germany (21%)
• United Kingdom (19%)
• France (13%)
• Benelux (9%)
• Spain (8%)
• Scandinavia (6%)
• Italy (6%)
• Switzerland (5%)
• Netherlands (3%)
• Portugal (3%)
• Ireland (3%)
• Austria (2%)
• rest of Europe (2%)

PACKAGE

We are able to provide you with

• The opportunity to nominate one author to write an independent unbiased white paper for the proposed feature running to approximately 2000 words
• A Search Engine Optimised Company Profile on the official Metabolic Disease Review Europe website
• A fully guaranteed precisely targeted circulation
• The reader response service in operation for 12 months after publication
• A complimentary copy of European Metabolic Review upon publication
• A strategically placed advertisement in Metabolic Disease Review Europe or additional editorial if preferred

Reprints

Quotations available upon request

BENEFITS

• Target senior level physicians throughout Europe engaged in the clinical assessment, diagnosis, treatment and management of overweight and obesity.
• Reach endocrinologists, endocrine surgeons, cardiologists, bariatric surgeons, selected high referring, primary care physicians and dieticians
• Demonstrate your commitment in this therapeutic area by sharing a platform with respected key opinion leaders and thought leaders in this field.
• Increase your share of voice in this growing and competitive marketplace.

Publication Date

March 2009
September 2009