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O papel dos antidiabéticos no controlo da obesidade
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Nos últimos trinta anos, a prevalência de obesidade tem vindo a aumentar a uma velocidade alarmante, estimando-se que, até 2030, aproximadamente metade da população apresente excesso de peso ou obesidade. Este crescimento pode dever-se a múltiplos fatores, nomeadamente, o estilo de vida das sociedades modernas, fácil acesso a alimentos não saudáveis, um estilo de vida mais sedentário e fatores ambientais que limitam o acesso dos indivíduos a um estilo de vida mais saudável. A acumulação de lípidos em órgãos não especializados, como o fígado e o músculo esquelético, contribui para o desenvolvimento de distúrbios metabólicos, nomeadamente, resistência à insulina, Diabetes Mellitus tipo 2, doenças cardiovasculares, doença hepática e cancro. A obesidade constitui uma doença multifatorial complexa, resultando de uma combinação de fatores que levam a um balanço energético positivo, onde a ingestão calórica supera o seu gasto. Ao longo dos anos, a terapêutica da obesidade tem vindo a alterar-se, tendo passado por vários fármacos até chegar aos que hoje se conhecem, no entanto, este tratamento é ainda muito associado a motivações estéticas, existindo poucas opções terapêuticas aprovadas. Atualmente, existem vários fármacos com potencial para tratamento da obesidade, nomeadamente, a combinação de Fentermina com Topiramato, a utilização conjunta de Naltrexona e Bupropiom, o Orlistato e os Análogos do Péptido Glucagon-like 1. A falta de opções terapêuticas e a observação de que os Antidiabéticos potenciavam a redução do peso corporal nos seus utilizadores, levou à exploração desta classe de fármacos como potencial tratamento para a obesidade e o excesso de peso. Os principais antidiabéticos utilizados são os Análogos do Péptido Glucagon-like 1, tendo vindo a ser também explorados a metformina, os Inibidores do SGLT2 e os análogos da Amilina. Todos estes fármacos apresentam resultados, no entanto, trazem associados efeitos adversos que reduzem a qualidade de vida dos doentes, contribuindo muitas vezes para a interrupção do tratamento. A gestão dos efeitos adversos e a educação dos doentes para a correta execução do tratamento demonstrou-se crucial, sendo este um ponto importante da intervenção do farmacêutico nesta patologia.
Over the last thirty years, the prevalence of obesity has been increasing at an alarming rate, and it is estimated that by 2030 approximately half of the population will be overweight or obese. This growth may be due to multiple factors, such as the lifestyle of modern societies, easy access to unhealthy foods, a more sedentary lifestyle and environmental factors that limit individuals' access to a healthier lifestyle. The accumulation of lipids in non-specialized organs, such as the liver and skeletal muscle, contributes to the development of metabolic disorders, namely Insulin Resistance, Type 2 Diabetes Mellitus, cardiovascular disease, liver disease and cancer. Obesity is a complex multifactorial disease, resulting from a combination of factors that lead to a positive energy balance, where calorie intake exceeds calorie expenditure. Over the years, the treatment of obesity has changed, going through various drugs until it reached the ones we know today; however, this treatment is still very much associated with aesthetic motivations and there are few approved therapeutic options. Currently, there are several drugs with potential for treating obesity, namely the combination of Phentermine and Topiramate, the combined use of Naltrexone and Bupropion, Orlistat and Glucagon-like Peptide-1 Receptor Agonists. The lack of therapeutic options and the observation that antidiabetics potentiated the reduction of body weight in their users led to the exploration of this class of drugs as a potential treatment for obesity and overweight. The main antidiabetics used are Glucagon-like Peptide-1 Receptor Agonists, while Metformin, SGLT2 Inhibitors and Amylin analogues are also being explored. All these drugs have shown results, but they are associated with adverse effects that reduce patients' quality of life and often lead to treatment discontinuation. Managing adverse effects and educating patients on the correct course of treatment has proved crucial, and this is an important aspect of the pharmacist's intervention in this condition.
Over the last thirty years, the prevalence of obesity has been increasing at an alarming rate, and it is estimated that by 2030 approximately half of the population will be overweight or obese. This growth may be due to multiple factors, such as the lifestyle of modern societies, easy access to unhealthy foods, a more sedentary lifestyle and environmental factors that limit individuals' access to a healthier lifestyle. The accumulation of lipids in non-specialized organs, such as the liver and skeletal muscle, contributes to the development of metabolic disorders, namely Insulin Resistance, Type 2 Diabetes Mellitus, cardiovascular disease, liver disease and cancer. Obesity is a complex multifactorial disease, resulting from a combination of factors that lead to a positive energy balance, where calorie intake exceeds calorie expenditure. Over the years, the treatment of obesity has changed, going through various drugs until it reached the ones we know today; however, this treatment is still very much associated with aesthetic motivations and there are few approved therapeutic options. Currently, there are several drugs with potential for treating obesity, namely the combination of Phentermine and Topiramate, the combined use of Naltrexone and Bupropion, Orlistat and Glucagon-like Peptide-1 Receptor Agonists. The lack of therapeutic options and the observation that antidiabetics potentiated the reduction of body weight in their users led to the exploration of this class of drugs as a potential treatment for obesity and overweight. The main antidiabetics used are Glucagon-like Peptide-1 Receptor Agonists, while Metformin, SGLT2 Inhibitors and Amylin analogues are also being explored. All these drugs have shown results, but they are associated with adverse effects that reduce patients' quality of life and often lead to treatment discontinuation. Managing adverse effects and educating patients on the correct course of treatment has proved crucial, and this is an important aspect of the pharmacist's intervention in this condition.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2024, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Obesidade Antidiabéticos Análogos do GLP-1 Terapêutica Farmacológica Mestrado Integrado - 2024