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Diagnosis and Management of Obesity: A Joint Statement by Practicing Endocrinologists

Journal of Diabetes Mellitus 2023年第2期13卷 77-92页

作者： Maya Barake Akram Echtay kamal hirbli Charles Saab Rita Medlej Paola Atallah Division of Endocrinology Clemenceau Medical Center Beirut Lebanon Division of Endocrinology Rafic Hariri University Hospital Beer Hassan Beirut Lebanon Division of Endocrinology LAU Medical Center-Rizk Hospital Beirut Lebanon Division of Endocrinology Sacré-Coeur Hospital Beirut Lebanon Division of Endocrinology H&#244tel-Dieu de France Hospital-USJ University Hospital Beirut Lebanon Division of Endocrinology Saint George Hospital University Medical Center Beirut Lebanon

Obesity is not always recognized as a primary disease, leading to shortage of insurance coverage, clear dispositions about therapeutic strategies, prevention programs and legislation. Worldwide, physicians face the challenge to design affordable and effective treatments against obesity, to improve patient health and wellbeing and reduce the burden on healthcare systems. While international guidelines for obesity management are available, straightforward recommendations applicable in developing countries are needed. In order to develop local consensus recommendations, a panel of endocrinologists with experience in overweight and obesity convened and provided opinions about obesity aetiology, diagnosis, and management, in a structured discussion. Opinions were then developed into recommendations. There was unanimous agreement on recognizing obesity as a disease, which could be diagnosed by any trained physician and best managed by endocrinologists or obesity-trained physicians. The panel reiterated that lifestyle and behaviour changes remain the cornerstone of treatment;underscoring, however, the need for pharmacotherapy or bariatric surgery in some cases. They also identified stakeholders in the fight against obesity (ministries, third-party payers, healthcare providers and others). The establishment of an obesity registry was encouraged, which will pave the way for enhanced obesity research and prevention programs. These recommendations, endorsed by the World Obesity Federation, would be of interest to clinicians worldwide. .

关键词： Obesity Nutrition Clinical Management Developing Countries Consensus

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Diabetes Management, Quality of Life and Treatment Satisfaction in Adult Population in Jordan and Lebanon, Observations from the SIMPLIFY Study

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Journal of Diabetes Mellitus 2020年第2期10卷 73-87页

作者： Paola Atallah Mohamed El-Zaheri Omar Abu-Hijleh Emile Andari Fares Haddad Hiba Hajar kamal hirbli Nadim Jarrah Rita Medlej Charles Saab Department of Endocrinology Saint George Hospital University Medical Center Beirut Lebanon Department of Endocrinology Jordan Hospital Medical Center Amman Jordan Endocrinology Department Notre Dame de Secours Hospital Byblos Lebanon Department of Endocrinology King Hussein Medical Center Amman Jordan Medical Department AstraZeneca Near East Beirut Lebanon Endocrinology Department Lebanese American University Medical Center Rizk Hospital Beirut Lebanon Department of Endocrinology Specialty Hospital Shmeisani Amman Jordan Department of Endocrinology Hotel Dieu de France Hospital Beirut Lebanon Department of Endocrinology and Metabolic Diseases Sacré Coeur Hospital Beirut Lebanon

Introduction: Type 2 Diabetes Mellitus (T2DM) has witnessed a rise in its prevalence worldwide and in the Middle East region. The overall burden associated with the disease is well characterized, but little is known about patient satisfaction in the region. The purpose of the study is to evaluate the quality of life (QoL) and treatment satisfaction of patients T2DM. Methods: The SIMPLIFY study was an observational, cross-sectional, multicenter, regional study that used patient-reported outcomes of T2DM patients in Jordan and Lebanon. Results: Patients were more satisfied when they were treated exclusively with oral medications, mainly metformin alone or combined with either sulfonylurea or dipeptidyl peptidase-4 inhibitor. Targets for glycated hemoglobin (HbA1c) values were better reached in patients treated with oral medications. Occurrence of comorbidities did not seem to be affected by oral or injectable medications or to affect patients’ satisfaction. Data highlighted a suboptimal screening for albuminuria and showed that most patients were overweight or obese and around 30% suffered from hypoglycemia episodes. Conclusion: Data shed the light on the management of T2DM in Jordan and Lebanon and suggested the need for a more comprehensive approach to T2DM management and selection of medications that would support weight control and a lower hypoglycemia incidence.

关键词： Diabetes Glycated Hemoglobin Clinical Management Patient Satisfaction Quality of Life

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