Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v7i3.5458
Abstract
Overweight and obesity are a global public health crisis closely linked to rising type 2 diabetes mellitus (T2DM). Over 60% of Chinese T2DM patients are overweight or obese, developing a vicious cycle of insulin resistance, pancreatic β-cell dysfunction, chronic inflammation and abnormal incretin signals that exacerbate metabolic disorders and weight gain. This population faces elevated risks of cardiovascular disease, chronic kidney disease and non-alcoholic fatty liver disease, along with higher mortality and heavy socioeconomic burdens. In the past decade, T2DM treatment has shifted from glucose-only control to a patient-centered model prioritizing weight loss and complication management. Major international and domestic guidelines identify weight loss of at least 5% as a core therapeutic goal, and recommend hypoglycemic agents with proven weight-lowering and cardiorenal benefits. New drugs including dorzagliatin (a glucokinase activator) and tirzepatide (a dual GIP/GLP-1 receptor agonist) have expanded treatment options for high-risk patients. Based on 2018-2026 high-quality literature from PubMed, Web of Science and CNKI, this review summarizes the pathophysiology linking obesity and T2DM, evaluates the efficacy and safety of current medications, and discusses individualized therapy, optimal combination regimens and full-cycle chronic disease management. It aims to provide concise, clinically practical references for frontline practice.
Keywords
overweight; obesity; type 2 diabetes mellitus; chronic disease management; pharmacological selection; individualized therapy
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[3] Chen X, et al. Multidimensional links between dietary behavior and cardiometabolic comorbidities: a network analysis. Diabetol Metab Syndr. 2025;17:278.
[4] Hu RY, et al. [Association between obesity and risk for all-cause mortality in patients with type 2 diabetes]. Zhonghua Liu Xing Bing Xue Za Zhi. 2024;45(4):520-526.
[5] Magkos F, Fraterrigo G, Yoshino J, et al. Effects of Moderate and Subsequent Progressive Weight Loss on Metabolic Function and Adipose Tissue Biology in Humans with Obesity. Cell Metab. 2016;23(4):591-601.
[6] American Diabetes Association Professional Practice Committee. 8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: Standards of Care in Diabetes—2024. Diabetes Care. 2024;47(Suppl 1):S145-S157.
[7] Varra FN, et al. Molecular and pathophysiological relationship between obesity and chronic inflammation in the manifestation of metabolic dysfunctions and their inflammation-mediating treatment options (Review). Mol Med Rep. 2024;29(6):95.
[8] Zeng Y, Wu Y, Zhang Q, Xiao X. Crosstalk between glucagon-like peptide 1 and gut microbiota in metabolic diseases. mBio. 2023;15(1):e02032-23.
[9] Zhao L, Cheng Z, Lu Y, et al. Tirzepatide for Weight Reduction in Chinese Adults With Obesity: The SURMOUNT-CN Randomized Clinical Trial. JAMA. 2024;332(7):551-560.
[10] Sattar N, Tanniou J, Würtz P, et al. Multidimensional cardiometabolic protection with SGLT2 inhibitors and GLP-1 receptor agonists in obesity, type 2 diabetes and hypertension. Metabol Open. 2026;30:100370.
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[12] Alfaris N, et al. GLP-1 single, dual, and triple receptor agonists for treating type 2 diabetes and obesity: a narrative review. EClinicalMedicine. 2024;75:102782.
[13] American Diabetes Association Professional Practice Committee. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025. Diabetes Care. 2025;48(Suppl 1):S181-S206.
[14] Wu YQ, Wang K, Su JY, et al. Efficacy and safety of dorzagliatin, a novel glucokinase activators, in the treatment of T2DM: A meta-analysis of randomized controlled trials. Medicine(Baltimore).2024;103(8):e36916.
[15] Spreckley M, Ruggiero CF, Brown A. Incretin therapies, nutrition, and food insecurity in the UK. Nat Med. 2026.
[16] Ammori BJ, et al. Medical and surgical management of obesity and diabetes: what's new? Diabet Med. 2020;37(2):203-210.
[17] Sridhar VS, et al. Making a case for the combined use of SGLT2 inhibitors and GLP1 receptor agonists for cardiorenal protection. J Bras Nefrol. 2020;42(4):467-477.
Copyright © 2026 Yue Kan, Jing Dong, Yanhui Liu, Jiachen Yao, Wenyan Li
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