Treatment intensification in type 2 diabetes mellitus and obesity

As Dr Pierce’s editorial points out, there is increasing evidence from bariatric surgery and intensive weight-loss approaches that it is possible to significantly improve type 2 diabetes (T2D) to the point of remission in some individuals.1 Thus, there is a need to rethink the current approach to diabetes management. Pursuing glycaemic control in T2D has resulted in treatment intensification, including insulin initiation. This approach, however, commonly results in weight gain. We describe two cases questioning the inevitability of beta-cell failure in T2D, and highlight the need for judicious treatment intensification. A 65-year-old female with …