REPORT & GUIDELINES
Clinical guidelines on the management of individuals with overweight/obesity and glucose metabolism disorders – 2026. Position statement of Diabetes Poland
1
Department of Internal Medicine and Diabetology, Karol Marcinkowski Poznan University of Medical Sciences, Poland
2
Department of Metabolic Diseases, Jagiellonian University Medical College, Kraków; University Hospital, Kraków, Poland
3
Department of Internal Medicine and Diabetology, Medical University of Lodz, Poland
4
Psychodiabetology Research Unit, Department of Metabolic Diseases, and Department of Psychiatry, Jagiellonian University Medical College, Kraków; University Hospital, Kraków, Poland
5
Department of Diabetology and Internal Medicine, Medical University of Warsaw, Poland
6
Department of Human Pathophysiology, Collegium Medicum, University of Rzeszów, Poland
7
Department of Internal Medicine, Medical University of Lublin, Poland
8
Department of Paediatrics, Endocrinology and Diabetology with Cardiology Subdivision, Medical University of Białystok, Poland
9
Sexology Laboratory, Department of Psychiatry and Psychotherapy, Jagiellonian University Medical College, Kraków, Poland
10
Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
11
Department of Children’s Diabetology and Lifestyle Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
12
Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Poland
13
Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Poland
14
Department of Paediatrics, Diabetology and Endocrinology, Medical University of Gdańsk, Poland
15
Department of Hypertension and Diabetology, Medical University of Gdańsk, Poland
16
Department of Human Nutrition, Medical University of Warsaw, Poland
17
Department of Biological and Environmental Psychiatry, Jagiellonian University Medical College, Kraków
18
Clinical Department of Adult, Child and Adolescent Psychiatry, University Hospital, Kraków, Poland
19
Department of Nephrology, Hypertension and Internal Medicine, Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
20
Department of Internal Medicine, Diabetology and Cardiometabolic Disorders, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
21
Department of Paediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Poland
22
Department of Paediatric Diabetology and Paediatrics, Medical University of Warsaw, Poland
23
Department of Reproduction, Department of Perinatal Medicine, Karol Marcinkowski Poznan University of Medical Sciences, Poland
24
Third Psychiatric Department, Institute of Psychiatry and Neurology, Warsaw, Poland
25
Second Department of General, Vascular and Oncological Surgery, Medical University of Warsaw, Poland
26
Department of Clinical Genetics, Medical University of Lodz, Poland
27
Department of Paediatrics, Endocrinology, Diabetology and Metabolic Diseases, Wroclaw Medical University, Poland
Publication date: 2026-11-04
Current Topics in Diabetes 2026;6(2):1-122
KEYWORDS
ABSTRACT
Obesity and glucose metabolism disorders are among the principal public health challenges of the twenty-first century, and their clinical and epidemiological burden continues to grow despite expanding educational and preventive efforts. Although Diabetes Poland (PTD) has issued annual guidelines for the management of diabetes since 2005, no dedicated Polish recommendations had previously addressed the combined issue of overweight/obesity and glucose metabolism disorders. This document presents the first edition of such recommendations, developed by a multidisciplinary expert panel comprising specialists in diabetology, endocrinology, paediatrics, psychiatry, psychotherapy, nephrology, cardiology, hypertensiology, and human nutrition. The recommendations are based on current clinical trial evidence and existing international guidelines, with each recommendation assigned a graded strength of supporting evidence. The statement frames obesity as a complex, chronic disease of genetic, metabolic, behavioural, and environmental origin and addresses its definition, terminology, diagnosis (body mass index, waist circumference, and body composition, with age- and sex-adjusted assessment in children), epidemiology, pathogenesis, and secondary causes. It reviews the main clinical consequences, including cardiovascular-kidney-metabolic complications, hypertension, steatotic liver disease, and sexual dysfunction, and provides detailed guidance on treatment goals and monitoring, therapeutic education, dietary and lifestyle interventions, pharmacotherapy, and bariatric surgery. Separate recommendations are provided for children and adolescents, for adults over 65 years, and for the organisation of care. These recommendations integrate contemporary evidence into a practical framework intended to standardize and improve the care of people with overweight/obesity and glucose metabolism disorders.
REFERENCES (280)
1.
American Diabetes Association Professional Practice Committee for Diabetes. 8. Obesity and weight management for the prevention and treatment of diabetes: Standards of care in diabetes – 2026. Diabetes Care 2026; 49 (Supplement_1): S166-S182.
3.
Rubino F, Cummings DE, Eckel RH, et al. Definition and diagnostic criteria of clinical obesity. Lancet Diabetes Endocrinol 2025; 13: 221-262.
4.
World Health Organization. Obesity and overweight [Internet]. Geneva: World Health Organization; 2025.
5.
Lau DCW, Wharton S. Canadian Adult Obesity Clinical Practice Guidelines: The Science of Obesity. Available at: https://obesitycanada.ca/guide... (accessed: 27 April 2026).
6.
Dunkel KA. New Obesity Definitions – Watch or Warning? JAMA Netw Open 2025; 8: e2549012.
7.
Fourman LT, Awwad A, Gutiérrez-Sacristán A, et al. Implications of a new obesity definition among the All of Us cohort. JAMA Netw Open 2025; 8: e2537619.
8.
Ciudin A, Baker JL, Belančić A, et al. Framework for the pharmacological treatment of obesity and its complications from the European Association for the Study of Obesity (EASO): 2026 update. Nat Med 2026; 32: 1962-1966.
9.
Mazur A, Zachurzok A, Baran J, et al. Childhood obesity: position statement of Polish Society of Pediatrics, Polish Society for Pediatric Obesity, Polish Society of Pediatric Endocrinology and Diabetes, the college of family physicians in poland and Polish association for study on obesity. Nutrients 2022; 14: 3806.
10.
World Health Organization. WHO child growth standards: length/height-for-age, weight-for-length, weight-for-height and body mass index-for-age. Geneva: WHO; 2006.
11.
European Association for the Study of Obesity (EASO). The heavy burden of obesity in Europe. Obes Facts 2023; 16: 113-120.
12.
World Health Organization. Obesity and overweight. Fact sheet. Geneva: World Health Organization; 2024.
13.
World Obesity Federation. World Obesity Atlas 2025: Overweight, obesity and non-communicable diseases. London: World Obesity Federation; 2025.
14.
OECD. Health at a Glance: Europe 2022 – State of Health in the EU Cycle. Paris: OECD Publishing; 2022.
15.
Stahl-Pehe A, Bächle C, Castillo K, et al. Prevalence of type 1 and type 2 diabetes in children and adolescents in Europe. Pediatr Diabetes 2022; 23: 1009-1019.
16.
Drygas W, Niklas AA, Piotrowski W, et al. Multi-centre national population health examination survey (WOBASZ III) – assumptions, methods and selected results. Kardiol Pol 2022; 80: 697-708.
17.
Narodowy Fundusz Zdrowia [National Health Fund]. Cukrzyca. Raport NFZ 2023 [Diabetes. NFZ Report 2023]. Warsaw: NFZ; 2023.
18.
Zdrojewski T, Więcek A, Rutkowski M, et al. PolSenior2 study – design and selected results concerning cardiometabolic risk in older adults. Kardiol Pol 2021; 79: 1183-1191.
19.
Han C, Zhang H, Luo X, et al. Global prevalence of prediabetes in children and adolescents: a meta-analysis. J Diabetes 2022; 14: 673-690.
20.
WHO Regional Office for Europe. WHO European Childhood Obesity Surveillance Initiative (COSI): report on the sixth round of data collection, 2022-2024. Copenhagen: WHO Regional Office for Europe; 2025.
21.
Zhang X, Liu J, Ni Y, et al. Global prevalence of overweight and obesity in children and adolescents: a systematic review and meta-analysis. JAMA Pediatr 2024; 178: 800-813.
22.
Brzeziński M, Jankowski M, Jankowska A, et al. Is there a rapid increase in prevalence of obesity in Polish children and adolescents? Arch Med Sci 2017; 14: 22-29.
23.
Chylińska-Frątczak A, Michalak A, Baranowska-Jaźwiecka A, et al. Incidence of hyperglycaemic disorders in children and adolescents with obesity. Pediatr Endocrinol Diabetes Metab 2022; 28: 274-280.
24.
Fijałkowska A, Oblacińska A, Korzycka M, et al. Childhood obesity surveillance initiative (COSI) in Poland – implementation of two rounds of the study. J Mother Child 2020; 24: 29-38.
25.
Wu H, Lau ESH, Ma RCW, et al. Worldwide estimates of incidence of type 2 diabetes in children and adolescents in 2021. Diabetes Res Clin Pract 2022; 185: 109785.
26.
Matthews DR, Seeley RJ, Zeltser LM, et al. Obesity pathogenesis: an Endocrine Society scientific statement. Endocr Rev 2017; 38: 267-296.
27.
Betley JN, Xu S, Cao ZF, et al. Neurons for hunger and thirst transmit a negative-valence teaching signal. Nature 2015; 521: 180-185.
28.
Stemmer K, Muller ID, DiMarchi RD, et al. CNS-targeting pharmacological interventions for the metabolic syndrome. J Clin Invest 2019; 129: 4058-4071.
29.
Egecioglu E, Skibicka KP, Hansson C, et al. Hedonic and incentive signals for body weight control. Physiol Behav 2011; 104: 748-753.
30.
Koliaki C, Liatis S, Dalamaga M, et al. The implication of gut hormones in the regulation of energy homeostasis and their role in the pathophysiology of obesity. Curr Obes Rep 2020; 9: 255-271.
31.
Karczewska-Kupczewska M, Stefanowicz M, Nikołajuk A, et al. Weight-reducing dietary intervention increases the ability of hyperinsulinemia to suppress serum ghrelin concentration in individuals with obesity. J Nutr 2024; 154: 1631-1639.
32.
Ascaso JF, Pardo S, Real JT, et al. Diagnosing insulin resistance by simple quantitative methods in subjects with normal glucose metabolism. Diabetes Care 2003; 26: 3320-3325.
33.
Loos RJF, Yeo GSH. The genetics of obesity: from discovery to biology. Nat Rev Genet 2022; 23: 120-133.
34.
Frayling TM, Timpson NJ, Weedon MN, et al. A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science 2007; 316: 889-894.
35.
Ekelund U, Steene-Johannessen J, Brown WJ, et al. Does physical activity attenuate the detrimental association of sitting time with mortality? Lancet 2016; 388: 1302-1310.
36.
Helmerhorst HJF, Wijndaele K, Brage S, et al. Objectively measured sedentary time may predict insulin resistance independently of moderate- and vigorous-intensity physical activity. Diabetologia 2009; 52: 1776-1779.
37.
Konttinen H. Emotional eating and obesity in adults: the role of depression, sleep and genes. Proc Nutr Soc 2020; 79: 283-289.
38.
Cyranka K, Snoek F, Hermanns N, et al. Obesity-related distress and obesity burnout: towards a conceptual framework for disease-specific emotional burden in obesity. Diabetes Obes Metab 2026; 28: 3457-3461.
39.
British Psychological Society. The causes of obesity – a complex interaction. In: Psychological perspectives on obesity: Addressing policy, practice and research priorities. British Psychological Society; 2019.
40.
Umano GR, Bellone S, Buganza R, et al. Early roots of childhood obesity: risk factors, mechanisms, and prevention strategies. Int J Mol Sci 2025; 26: 7388.
41.
Blaauwendraad SM, Kamphuis ASJ, Ruiz-Ojeda FJ, et al. Risk factors in the first 1000 days of life associated with childhood obesity: a systematic review and risk factor quality assessment. Obes Rev 2026; 27: e70025.
42.
Pasquali R, Casanueva F, Haluzik M, et al. European Society of Endocrinology clinical practice guideline: Endocrine work-up in obesity. Eur J Endocrinol 2020; 182: 1-32.
43.
Ambrosi B, Masserini B, Iorio L, et al. Relationship of thyroid function with body mass index and insulin resistance in euthyroid obese subjects. J Endocrinol Invest 2010; 33: 640-643.
44.
Song RH, Wang B, Yao QM, et al. The impact of obesity on thyroid autoimmunity and dysfunction: a systematic review and meta-analysis. Front Immunol 2019; 10: 2349.
45.
Krentowska A, Kowalska I. Metabolic syndrome and its components in different phenotypes of polycystic ovary syndrome. Diabetes Metab Res Rev 2022; 38: e3464.
46.
Kowalska I, Strączkowski M, Nikołajuk A, et al. Serum visfatin in relation to insulin resistance and markers of hyperandrogenism in lean and obese women with polycystic ovary syndrome. Hum Reprod 2007; 22: 1824-1829.
47.
Forslund M, Wändell P, Forsberg L, et al. GLP-1 receptor agonist treatment in women with polycystic ovary syndrome: a systematic review and meta-analysis. Eur J Endocrinol 2026; 194: 25.
48.
Salonia A, Capogrosso P, Boeri L, et al. EAU guidelines on male sexual and reproductive health: 2025 update. Eur Urol 2025; 88: 76-102.
49.
Jayasena CN, Devine K, Barber K, et al. Female hypogonadism guideline. Clin Endocrinol (Oxf) 2024; 101: 409-442.
50.
Hjelholt A, Høgild M, Bak AM, et al. Growth hormone and obesity. Endocrinol Metab Clin North Am 2020; 49: 239-250.
51.
Jameson JL, De Groot LJ. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia (PA): Elsevier; 2016.
52.
Roth CL, McCormack SE. Acquired hypothalamic obesity. Diabetes Obes Metab 2024; 26: 34-45.
53.
Collet TH, Schwitzgebel V. Precision medicine in rare obesity. Front Nutr 2024; 11: 1509994.
54.
Dollfus H, Lilien MR, Maffei P, et al. Bardet-Biedl syndrome. Eur J Hum Genet 2024; 32: 1347-1360.
55.
Gill H, Gill B, El-Halabi S, et al. Antidepressants and weight change. Obesity (Silver Spring) 2020; 28: 2064-2072.
56.
VA/DoD Clinical Practice Guideline for the Management of Adult Overweight and Obesity. Version 4.0. Washington (DC): U.S. Department of Veterans Affairs, Department of Defense; 2025.
57.
Rooney MR, Wallace AS, Echouffo Tcheugui JB, et al. Prediabetes is associated with elevated risk of clinical outcomes even without progression to diabetes. Diabetologia 2025; 68: 357-366.
58.
Schlesinger S, Neuenschwander M, Barbaresko J, et al. Prediabetes and risk of mortality, diabetes-related complications and comorbidities: umbrella review of meta-analyses of prospective studies. Diabetologia 2022; 65: 275-285.
59.
Bianchettin RG, Lavie CJ, Lopez-Jimenez F. Challenges in cardiovascular evaluation and management of obese patients: JACC state-of-the-art review. J Am Coll Cardiol 2023; 81: 490-504.
60.
Kim MS, Kim WJ, Khera AV, et al. Association between adiposity and cardiovascular outcomes: an umbrella review and meta-analysis of observational and Mendelian randomization studies. Eur Heart J 2021; 42: 3388-3403.
61.
Liao J, Qiu M, Li J, Li Y, Han Y. Association of visceral adipose tissue with hypertension: Results from the NHANES 2011-2018 and Mendelian randomization analyses. J Clin Hypertens (Greenwich) 2025; 27: e14953.
62.
NCD Risk Factor Collaboration (NCD-RisC). General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7.5 million participants. Lancet 2024; 404: 851-863.
63.
D’Agati VD, Chagnac A, de Vries AP, et al. Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis. Nat Rev Nephrol 2016; 12: 453-471.
64.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 2024; 105 (Suppl 4): S117-S314.
65.
Dhurandhar Y, Tomar S, Das A, et al. Chronic inflammation in obesity and neurodegenerative diseases: exploring the link in disease onset and progression. Mol Biol Rep 2025; 52: 424.
66.
Karczewska-Kupczewska M, Tarasów E, Nikołajuk A, et al. The effect of insulin infusion on the metabolites in cerebral tissues assessed with proton magnetic resonance spectroscopy in young healthy subjects with high and low insulin sensitivity. Diabetes Care 2013; 36: 2787-2793.
67.
Wang J, Yang DL, Chen ZZ, Gou BF. Associations of body mass index with cancer incidence among populations, genders, and menopausal status: a systematic review and meta-analysis. Cancer Epidemiol 2016; 42: 1-8.
68.
Deshmukh B, Ajay AK, Bhat MK. Obesity and cancer: relevance of DNA damage response. Transl Oncol 2026; 65: 102657.
69.
Brown A, Flint SW, Batterham RL. Pervasiveness, impact and implications of weight stigma. EClinicalMedicine 2022; 47: 101408.
70.
Jebeile H, Kelly AS, O’Malley G, Baur LA. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol 2022; 10: 351-365.
71.
European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO). EASL–EASD–EASO clinical practice guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol 2024; 81: 492-542.
72.
Roden M, Shulman GI. The integrative biology of type 2 diabetes. Nature 2019; 576: 51-60.
73.
James DE, Stöckli J, Birnbaum MJ. The aetiology and molecular landscape of insulin resistance. Nat Rev Mol Cell Biol 2021; 22: 751-771.
74.
Ndumele CE, Neeland IJ, Tuttle KR, et al. A synopsis of the evidence for the science and clinical management of cardiovascular-kidney-metabolic (CKM) syndrome: a scientific statement from the American Heart Association. Circulation 2023; 148: 1636-1664.
75.
Ndumele CE, Rangaswami J, Chow SL, et al. Cardiovascular-kidney-metabolic health: a presidential advisory from the American Heart Association. Circulation 2023; 148: 1606-1635.
76.
Vora J, Cherney D, Kosiborod MN, et al. Inter-relationships between cardiovascular, renal and metabolic diseases: Underlying evidence and implications for integrated interdisciplinary care and management. Diabetes Obes Metab 2024; 26: 1567-1581.
77.
Byrne CD, Armandi A, Pellegrinelli V, et al. Metabolic dysfunction-associated steatotic liver disease: a condition of heterogeneous metabolic risk factors, mechanisms and comorbidities requiring holistic treatment. Nat Rev Gastroenterol Hepatol 2025; 22: 314-328.
78.
Younossi ZM, Kalligeros M, Henry L. Epidemiology of metabolic dysfunction-associated steatotic liver disease. Clin Mol Hepatol 2025; 31 (Suppl): S32-S50.
79.
Huang DQ, Wong VWS, Rinella ME, et al. Metabolic dysfunction-associated steatotic liver disease in adults. Nat Rev Dis Primers 2025; 11: 14.
80.
Stefan N, Yki-Järvinen H, Neuschwander-Tetri BA. Metabolic dysfunction-associated steatotic liver disease: heterogeneous pathomechanisms and effectiveness of metabolism-based treatment. Lancet Diabetes Endocrinol 2025; 13: 134-148.
81.
Cusi K, Abdelmalek MF, Apovian CM, et al. Metabolic dysfunction-associated steatotic liver disease (MASLD) in people with diabetes: the need for screening and early intervention. A consensus report of the American Diabetes Association. Diabetes Care 2025; 48: 1057-1082.
82.
Yang W, Jin Q, Xiao D, et al. Interaction mechanism and intervention strategy between metabolic dysfunction-associated steatotic liver disease and intestinal microbiota. Front Microbiol 2025; 16: 1597995.
83.
Chan KE, Ong EYH, Chung CH, et al. Longitudinal outcomes associated with metabolic dysfunction-associated steatotic liver disease: a meta-analysis of 129 studies. Clin Gastroenterol Hepatol 2024; 22: 488-498.e14.
84.
Bilson J, Mantovani A, Byrne CD, et al. Steatotic liver disease, MASLD and risk of chronic kidney disease. Diabetes Metab 2024; 50: 101506.
85.
Bian H, Ma J, Qu S, et al. The evolving concept from Cardiovascular-kidney-metabolic syndrome to metabolic associated liver-cardiovascular-kidney syndrome: insights from endocrinology. Rev Endocr Metab Disord Published online February 2, 2026.
86.
Theodorakis N, Nikolaou M. From cardiovascular-kidney-metabolic syndrome to cardiovascular-renal-hepatic-metabolic syndrome: proposing an expanded framework. Biomolecules 2025; 15: 213.
87.
Porst H, Reisman Y, editors. The ESSM Syllabus of Sexual Medicine. Amsterdam: Medix Publishers; 2012.
88.
Kolotkin RL, Zunker C, Østbye T. Sexual functioning and obesity: a review. Obesity (Silver Spring) 2012; 20: 2325-2333.
89.
Saadedine M, Faubion SS, Grach SL, et al. Association between obesity and female sexual dysfunction: a review. Sex Med Rev 2024; 12: 154-163.
90.
Li H, Xu W, Wang T, et al. Effect of weight loss on erectile function in men with overweight or obesity: a meta-analysis of randomised controlled trials. Andrologia 2022; 54: e14250.
91.
Ng Tang Fui M, Hoermann R, Prendergast LA, et al. Testosterone treatment in dieting obese men with low testosterone levels: randomized placebo-controlled trial. Int J Obes 2017; 41: 420-426.
92.
Aversa A, Francomano D, Bruzziches R, et al. Effects of vardenafil on sexual distress in men with obesity. Int J Impot Res 2012; 24: 122-125.
93.
Biernikiewicz M, Szuster E, Pawlikowska-Gorzelańczyk A, et al. Prevalence and incidence of erectile dysfunction in men with overweight and obesity: a systematic literature review. Obes Rev 2026; 27: e70053.
94.
Salari N, Hasheminezhad R, Sedighi T, et al. The global prevalence of sexual dysfunction in obese and overweight women: a systematic review and meta-analysis. BMC Womens Health 2023; 23: 375.
95.
Ferrández Infante A, Novella Arribas B, Khan KS, et al. Obesity and female sexual dysfunctions: a systematic review with meta-analysis. Semergen 2023; 49: 102022.
96.
Gao Z, Liang Y, Deng W, et al. Impact of bariatric surgery on female sexual function in obese patients: a meta-analysis. Obes Surg 2020; 30: 352-364.
97.
Aversa A, Bruzziches R, Francomano D, et al. Weight loss by multidisciplinary intervention improves endothelial and sexual function in obese fertile women. J Sex Med 2013; 10: 1024-1033.
98.
Esposito K, Giugliano F, Di Palo C, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA 2004; 291: 2978-2984.
99.
Loh HH, Shahar MA, Loh HS, et al. Female sexual dysfunction after bariatric surgery in women with obesity: a systematic review and meta-analysis. Scand J Surg 2022; 111: 14574969211072395.
100.
Xu J, Wu Q, Zhang Y, et al. Effect of bariatric surgery on male sexual function: a systematic review and meta-analysis. Sex Med 2019; 7: 270-281.
101.
Syed AH, Chandnani A, Khan A, et al. Association of weight loss with improved sexual function in females. Cureus 2021; 13: e16849.
102.
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 – 2025. Diabetes Care 2025; 48: 167-180.
103.
American Diabetes Association Professional Practice Committee for Obesity. Pharmacologic treatment of obesity in adults: Standards of care in overweight and obesity. BMJ Open Diabetes Res Care 2026; 13 (Suppl 1): e005729.
104.
Baum A, Scarpa J, Bruzelius E, Tamler R, Basu S, Faghmous J. Targeting weight loss interventions to reduce cardiovascular complications of type 2 diabetes: a machine learning-based post-hoc analysis of heterogeneous treatment effects in the look AHEAD trial. Lancet Diabetes Endocrinol 2017; 5: 808-815.
105.
Blüher M. An overview of obesity-related complications: the epidemiological evidence linking body weight and other markers of obesity to adverse health outcomes. Diabetes Obes Metab 2025; 27: 3-19.
106.
Global Cardiovascular Risk Consortium, Magnussen C, Ojeda FM, et al. Global effect of modifiable risk factors on cardiovascular disease and mortality. N Engl J Med 2023; 389: 1273-1285.
107.
Taylor R. Type 2 diabetes and remission: practical management guided by pathophysiology. J Intern Med 2021; 289: 754-770.
108.
Malhotra A, Grunstein RR, Fietze I, et al. Tirzepatide for the treatment of obstructive sleep apnea and obesity. N Engl J Med 2024; 391: 1193-1205.
109.
Miranda S, Choudhari J, Chauhan N, Parmar MS. Impact of semaglutide on lipid profiles in overweight and obese non-diabetic adults: a systematic review and meta-analysis of randomized controlled trials. Eur J Pharmacol 2025; 1003: 177953.
110.
Hampl SE, Hassink SG, Skinner AC, et al. Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics 2023; 151: e2022060640.
111.
Nishi SK, Kavanagh ME, Ramboanga K, et al. Effect of digital health applications with or without gamification on physical activity and cardiometabolic risk factors: a systematic review and meta-analysis of randomized controlled trials. EClinicalMedicine 2024; 76: 102798.
112.
Norman K, Burrows L, Chepulis L, et al. Understanding weight management experiences from patient perspectives: qualitative exploration in general practice. BMC Prim Care 2023; 24: 45.
113.
Ramos-Lopez O, Martinez-Urbistondo D, Navas-Carretero S, et al. Health and liver diagnostic markers influencing glycemia in subjects with prediabetes: preview study. Diagnostics (Basel) 2024; 14: 2895.
114.
Aroda VR, Krause-Steinrauf H, Kazemi EJ, et al. Clinical and metabolic characterization of adults with type 2 diabetes by age in the GRADE cohort. Diabetes Care 2022; 45: 1512-1521.
115.
Brauchmann J, Laudenbach L, Kapp P, et al. Discrepancies between recommendations in evidence-based guidelines for the management of obesity in adolescents and adults: an evidence map. Obes Rev 2025; 26: e13945.
116.
Tuccinardi D, Masi D, Watanabe M, et al. Precision obesity medicine: a phenotype-guided framework for pharmacologic therapy across the lifespan. J Endocrinol Invest 2025; 48: 2761-2798.
117.
American Diabetes Association Professional Practice Committee for Diabetes. 5. Facilitating positive health behaviors and well-being to improve health outcomes: standards of care in diabetes – 2026. Diabetes Care 2026; 49 (Suppl 1): S89-S131.
118.
Polskie Towarzystwo Diabetologiczne [Diabetes Poland]. Zalecenia kliniczne dotyczące postępowania u osób z cukrzycą – 2026. Stanowisko Polskiego Towarzystwa Diabetologicznego [Clinical Recommendations on the Management of Individuals with Diabetes – 2026. Position Statement of Diabetes Poland]. Curr Top Diabetes 2026; 6: 1-172.
119.
Lean ME, Leslie WS, Barnes AC, et al. 5-year follow-up of the randomised Diabetes Remission Clinical Trial (DiRECT): extension study. Lancet Diabetes Endocrinol 2024; 12: 233-246.
120.
American Diabetes Association Professional Practice Committee. 14. Children and adolescents: standards of care in diabetes – 2025. Diabetes Care 2025; 48 (Suppl 1): S283-S305.
121.
International Society for Pediatric and Adolescent Diabetes (ISPAD). ISPAD clinical practice consensus guidelines 2022-2024: Nutrition, obesity, and type 2 diabetes in children and adolescents. Pediatr Diabetes 2022-2024; 23 (Suppl 27): 1-350.
122.
Kelly AS, Auerbach P, Barrientos-Perez M, et al. A framework for pediatric obesity management. N Engl J Med 2024; 390: 451-463.
123.
Skrzypek M, Krzyszycha RM, Goral K, et al. Nutritional intervention for management of obesity in children and adolescents. Med Og Nauk Zdr 2021; 27: 13-22.
124.
Cheong L, Law LSC, Tan LYL, et al. Medical nutrition therapy for women with gestational diabetes: current practice and future perspectives. Nutrients 2025; 17: 1210.
125.
Calcaterra V, Verduci E, Milanta Ch, et al. Benefits of the Mediterranean diet on inflammaging in childhood obesity. Nutrients 2024; 16: 1286.
126.
Yao Q, de Araujo CD, Juul F, et al. Isocaloric replacement of ultraprocessed foods and weight loss in the POUNDS lost trial. Obesity (Silver Spring) 2024; 32: 1281-1289.
127.
Rychlik E, Stoś K, Woźniak A, et al. Normy żywienia dla populacji Polski [Nutritional norms for the Polish population]. Narodowy Instytut Zdrowia Publicznego PZH-PIB; 2024.
128.
Sullivan VK, Kim H, Caulfield LE, et al. Plant-based dietary patterns and incident diabetes in the ARIC study. Diabetes Care 2024; 47: 803-809.
129.
KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney International; 2022.
130.
KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis 2020; 76 (Suppl 1): S1-S107.
131.
Pilla SJ, Yeh HC, Mitchell CM, et al.; DASH4D Collaborative Research Group. Dietary patterns, sodium reduction, and blood pressure in type 2 diabetes: the DASH4D randomized clinical trial. JAMA Intern Med 2025; 185: 937-946.
132.
Lohner S, Kuellenberg de Gaudry D, Toews I, et al. Non-nutritive sweeteners for diabetes mellitus. Cochrane Database Syst Rev 2020; 5: CD012885.
133.
Weight gain during pregnancy. Committee opinion no. 548. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013; 121: 210-212.
134.
Llamosas-Falcón L, Rehm J, Bright S, et al. Alcohol consumption, BMI, and type 2 diabetes: systematic review and dose-response meta-analysis. Diabetes Care 2023; 46: 2076-2083.
135.
AL-Mhanna SB, Batrakoulis A, Wan Ghazali WS, et al. Effects of combined aerobic and resistance training on glycemic control, blood pressure, inflammation, cardiorespiratory fitness and quality of life in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis. PeerJ 2024; 12: e17525.
136.
Chen Y, Chen Z, Pan L, et al. Effect of moderate and vigorous aerobic exercise on incident diabetes in adults with obesity: a 10-year follow-up of a randomized clinical trial. JAMA Intern Med 2023; 183: 272-275.
137.
Mian Li, Jie Li, Yu Xu, et al. Effect of 5:2 regimens: Energy-Restricted diet or low-volume high-intensity interval training combined with resistance exercise on glycemic control and cardiometabolic health in adults with overweight/obesity and type 2 diabetes: a three-arm randomized controlled trial. Diabetes Care 2024; 47: 1074-1083.
138.
Warnick JL, Darling KE, Swartz Topor L, Jelalian E. Barriers to healthy behaviors: perspectives from teens with comorbid type 1 diabetes and overweight/obesity, caregivers, and pediatric endocrinologists. J Pediatr Psychol 2024; 49: 874-881.
139.
Stanford KI, Goodyear LJ. Exercise and type 2 diabetes: molecular mechanisms regulating glucose uptake in skeletal muscle. Adv Physiol Educ 2014; 38: 308-314.
140.
WHO guidelines on physical activity and sedentary behaviour. Available at: https://apps.who.int/iris/bits....
141.
Stein MJ, Weber A, Bamberg F, et al. Diurnal timing of physical activity in relation to obesity and diabetes in the German National Cohort (NAKO). Int J Obes (Lond) 2025; 49: 921-930.
142.
Zihao H, Xiaodong Z, Rihua H, et al. Physical activity and weight loss among adults with type 2 diabetes and overweight or obesity. A post hoc analysis of the look AHEAD trial. JAMA Network Open 2024; 7: e240219.
143.
Butryn ML, Webb V, Wadden TA. Behavioral treatment of obesity. Psychiatr Clin North Am 2011; 34: 841-859.
144.
Wadden TA, Tronieri JS, Butryn ML. Lifestyle modification approaches for the treatment of obesity in adults. Am Psychol 2020; 75: 235-251.
145.
Adam TC, Epel ES. Stress, eating and the reward system. Physiol Behav 2007; 91: 449-458.
146.
Volkow ND, Wang GJ, Baler RD. Reward, dopamine and the control of food intake: implications for obesity. Trends Cogn Sci 2011; 15: 37-46.
147.
Crone C, Fochtmann LJ, Attia E, et al. The American Psychiatric Association practice guideline for the treatment of patients with eating disorders. Am J Psychiatry 2023; 180: 167-171.
148.
Hudson JI, Hiripi E, Pope HG Jr, et al. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry 2007; 61: 348-358.
149.
Chaput JP, McHill AW, Cox RC, et al. The role of insufficient sleep and circadian misalignment in obesity. Nat Rev Endocrinol 2023; 19: 82-97.
150.
Peppard PE, Young T, Barnet JH, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013; 177: 1006-1014.
151.
Roenneberg T, Allebrandt KV, Merrow M, et al. Social jetlag and obesity. Curr Biol 2012; 22: 939-943.
152.
Spiegel K, Tasali E, Penev P, et al. Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004; 141: 846-850.
153.
Riemann D, Espie CA, Altena E, et al. The European insomnia guideline: an update on the diagnosis and treatment of insomnia 2023. J Sleep Res 2023; 32: e14035.
154.
Greer SM, Goldstein AN, Walker MP. The impact of sleep deprivation on food desire in the human brain. Nat Commun 2013; 4: 2259.
155.
Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67: 220-229.
156.
The Global Cardiovascular Risk Consortium. Global effect on cardiovascular risk factors on lifetime estimates. N Engl J Med 2025; 393: 125-138.
157.
Jastreboff AM, Aronne LJ, Ahmad NN, et al. SURMOUNT-1 investigators. Tirzepatide once weekly for the treatment of obesity. N Engl J Med 2022; 387: 205-216.
158.
Pi-Sunyer X, Astrup A, Fujioka K, et al. SCALE Obesity and Prediabetes NN8022-1839 Study Group. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med 2015; 373: 11-22.
159.
Wilding JPH, Batterham RL, Calanna S, et al.; STEP 1 Study Group. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med 2021; 384: 989-1002.
160.
Muller TD, Finnan B, Bloom SR, et al. Glucagon like peptide-1 (GLP-1). Mol Metabolism 2019; 30: 72-130.
161.
Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. SELECT Trial Investigators. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med 2023; 389: 2221-2232.
162.
Torgerson JS, Hauptman J, Boldrin MN, et al. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an ADJUNCT to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 2004; 27: 155-161.
163.
Greenway FL, Fujioka K, Plodkowski RA, et al.; COR-I Study Group. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2010; 376: 595-605.
164.
Ala M, Moheb Aleaba M. The blood pressure-lowering property of subcutaneous semaglutide: a systematic review, meta-analysis, and meta-regression. J Endocrinol Invest 2025; 48: 283-294.
165.
Krumholz HM, de Lemos JA, Sattar N, et al. Tirzepatide and blood pressure reduction: stratified analyses of the SURMOUNT-1 randomised controlled trial. Heart 2024; 110: 1165-1171.
166.
Siebenhofer A, Winterholer S, Jeitler K, et al. Long-term effects of weight-reducing drugs in people with hypertension. Cochrane Database Syst Rev 2021; 1: CD007654.
167.
Zhao X, Huang K, Zheng M, Duan J. Effect of liraglutide on blood pressure: a meta-analysis of liraglutide randomized controlled trials. BMC Endocr Disord 2019; 19: 4.
168.
Nissen SE, Wolski KE, Prcela L, et al. Effect of naltrexone – bupropion on major adverse cardiovascular events in overweight and obese patients with cardiovascular risk factors. JAMA 2016; 315: 990-1004.
169.
Mahar MU, Mahmud O, Ahmed S, et al. The effects of tirzepatide on lipid profile: a systematic review and meta-analysis of randomized controlled trials. J Obes Metab Syndr 2024; 33: 348-359.
170.
European Medicines Agency. Available at: https://www.ema.europa.eu/en/d... (accessed: 27 April 2026).
171.
Knowler WC, Barrett-Connor E, Fowler SE, et al.; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393-403.
172.
le Roux CW, Astrup A, Fujioka K, et al. Three years of liraglutide versus placebo for diabetes risk reduction and weight management in individuals with prediabetes. Lancet 2017; 389: 1399-1409.
173.
Wadden TA, Bailey TS, Billings LK, et al. Effect of subcutaneous semaglutide on weight loss and glycaemic control in adults with overweight or obesity and prediabetes (STEP 3). Diabetes Care 2021; 44: 1042-1051.
174.
Rubino DM, Greenway FL, Khalid U, et al. Effect of continued weekly subcutaneous semaglutide vs withdrawal on weight loss maintenance (STEP 4). JAMA 2021; 325: 1414-1425.
175.
McGowan BM, Brune JM, Capehorn M, et al. Efficacy and safety of once-weekly semaglutide 2.4 mg versus placebo in people with obesity and prediabetes (STEP 10): a randomised, double-blind, placebo-controlled, multicentre phase 3 trial. Lancet Diabetes Endocrinol 2024; 12: 631-642.
176.
Wharton S, Freitas P, Hjelmesæth J, et al. Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial. Lancet Diabetes Endocrinol 2025; 13: 949-963.
177.
Packer M, Zile MR, Kramer CM, et al. Tirzepatide for heart failure with preserved ejection fraction and obesity. N Engl J Med 2025; 392: 427-437.
178.
Wong VWS, Ekstedt M, Wong GLH, Hagström H. Changing epidemiology, global trends and implications for outcomes of NAFLD. J Hepatol 2023; 79: 842-852.
179.
Armstrong MJ, Gaunt P, Aithal GP, et al. Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre, double blind, randomised, placebo-controlled phase 2 study. Lancet 2016; 387: 679-690.
180.
Sanyal AJ, Newsome PN, Kliers I, et al. Phase 3 trial of semaglutide in metabolic dysfunction-associated steatohepatitis. N Engl J Med 2025; 392: 2089-2099.
181.
Loomba R, Hartman ML, Lawitz EJ, et al. Tirzepatide for metabolic dysfunction-associated steatohepatitis with liver fibrosis. N Engl J Med 2024; 391: 299-310.
182.
Furth SL, Colhoun HM, Kanbay M, et al. The relationship between obesity and chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) controversies conference. Kidney Int 2026; 109: 442-464.
183.
Grant CH, Bell S. Obesity and chronic kidney disease: the dual epidemic in cardiovascular health. Eur Cardiol 2025; 20: e28.
184.
Camilleri B, Bridson JM, Sharma A, Halawa A. From chronic kidney disease to kidney transplantation: the impact of obesity and its treatment modalities. Transplant Rev (Orlando) 2016; 30: 203-211.
185.
Abasheva D, Ortiz A, Fernandez-Fernandez B. GLP-1 receptor agonists in patients with chronic kidney disease and either overweight or obesity. Clin Kidney J 2024; 17: 19-35.
186.
Alicic RZ, Neumiller JJ, Tuttle KR. GLP-1 receptor agonists and next-generation metabolic hormone therapies in chronic kidney disease. Nat Rev Nephrol 2026; 22: 265-282.
187.
Bergmann NC, Davies MJ, Lingvay I, Knop FK. Semaglutide for the treatment of overweight and obesity: a review. Diabetes Obes Metab 2023; 25: 18-35.
188.
Thong KY, Walton C, Ryder REJ. Safety and efficacy of liraglutide 1.2 mg in patients with mild and moderate renal impairment: the ABCD nationwide liraglutide audit. Pract Diab 2013; 30: 71-76.
189.
Cherney DZI, Hadjadj S, Lawson J, et al. Hemoglobin A1c reduction with the GLP-1 receptor agonist semaglutide is independent of baseline eGFR: post hoc analysis of the SUSTAIN and PIONEER programs. Kidney Int Rep 2022; 7: 2345-2355.
190.
Perkovic V, Tuttle KR, Rossing P, et al. Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes. N Engl J Med 2024; 391: 109-121.
191.
Apperloo EM, Tuttle KR, Pavo I, et al. Tirzepatide associated with reduced albuminuria in participants with type 2 diabetes: Pooled post hoc analysis from the randomized active- and placebo-controlled SURPASS-1-5 clinical trials. Diabetes Care 2025; 48: 430-436.
192.
American Diabetes Association Professional Practice Committee for Diabetes. Chapter 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes-2026 Diabetes Care 2026; 49 (Suppl.): S246-S260.
193.
Chintam K, Chang AR. Strategies to treat obesity in patients with CKD. Am J Kidney Dis 2021; 77: 427-439.
194.
Drug and Therapeutics Bulletin. Naltrexone/bupropion for obesity. DTB 2017; 55: 126-129.
195.
European Medicines Agency. Mysimba (naltrexone hydrochloride/bupropion hydrochloride): product information (Article 20 procedure – product information). EMA; 2025 (updated document).
196.
Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al.; STEP-HFpEF Trial Committees and Investigators. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med 2023; 389: 1069-1084.
197.
Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016; 375: 311-322.
198.
Nicholls SJ, Pavo I, Bhatt DL, et al. Cardiovascular outcomes with tirzepatide versus dulaglutide in type 2 diabetes. N Engl J Med 2025; 393: 2409-2420.
199.
Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2021; 42: 3227-3337.
200.
Davies M, Færch L, Jeppesen OK, et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet 2021; 397: 971-984.
201.
Garvey WT, Frias JP, Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet 2023; 402: 613-626.
202.
Lingvay I, Bergenheim SJ, Buse JB, et al. Once-weekly semaglutide 7·2 mg in adults with obesity and type 2 diabetes (STEP UP T2D): a randomised, controlled, phase 3b trial. Lancet Diabetes Endocrinol 2025; 13: 935-948.
203.
Kueh MTW, Chew NWS, Al-Ozairi E, le Roux CW. The emergence of obesity in type 1 diabetes. Int J Obes (Lond) 2024; 48: 289-301.
204.
Dahlstrom EH, Sandholm N, Forsblom CM, et al. Body mass index and mortality in individuals with type 1 diabetes. J Clin Endocrinol Metab 2019; 104: 5195-5204.
205.
Karamanakos G, Kokkinos A, Dalamaga M, et al. Highlighting the role of obesity and insulin resistance in type 1 diabetes and its associated cardiometabolic complications. Curr Obes Rep 2022; 11: 180-202.
206.
Livingstone SJ, Looker HC, Hothersall EJ, et al. Risk of cardiovascular disease and total mortality in adults with type 1 diabetes: Scottish registry linkage study. PLoS Med 2012; 9: e1001321.
207.
Mathieu C, Zinman B, Hemmingsson JU, et al. Efficacy and safety of liraglutide added to insulin treatment in type 1 diabetes: the ADJUNCT ONE Treat-To-Target randomized trial. Diabetes Care 2016; 39: 1702-1710.
208.
Ahrén B, Hirsch IB, Pieber TR, et al. Efficacy and safety of liraglutide added to capped insulin treatment in subjects with type 1 diabetes: the ADJUNCT TWO randomized trial. Diabetes Care 2016; 39: 1693-1701.
209.
Park J, Ntelis S, Yunasan E, et al. Glucagon-like peptide 1 analogues as adjunctive therapy for patients with type 1 diabetes: an updated systematic review and meta-analysis. J Clin Endocrinol Metab 2023; 109: 279-292.
210.
Purcell AR, Zhen Xi M, Wong J, et al. Glucagon-like peptide-1 receptor agonist treatment reduces body weight and improves glycaemic outcomes in patients with concurrent overweight/obesity and type 1 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab 2026; 28: 296-305.
211.
Tan X, Pan X, Wu X, et al. Glucagon-like peptide-1 receptor agonists as add-on therapy to insulin for type 1 diabetes mellitus. Front Pharmacol 2023; 14: 975880.
212.
Dutta D, Karmul-Hasan ABM, Jindal R, et al. Impact of semaglutide use on glycemic and metabolic profile in adults with type 1 diabetes having overweight or obesity: a systematic review and meta-analysis. Medicine (Baltimore) 2025; 104: e46446.
213.
Snaith JR, Frampton R, Samocha-Bonet D, et al. Tirzepatide in adults with type 1 diabetes: a phase 2 randomized placebo-controlled clinical trial. Diabetes Care 2026; 49: 161-170.
214.
Galli M, Benenati S, Laudani C, et al. Cardiovascular effects and tolerability of GLP-1 receptor agonists: a systematic review and meta-analysis of 99,599 patients. J Am Coll Cardiol 2025; 86: 1805-1819.
215.
Pasqua MR, Tsoukas MA, Kobayati A, et al. Subcutaneous weekly semaglutide with automated insulin delivery in type 1 diabetes: a double-blind, randomized, crossover trial. Nat Med 2025; 31: 1239-1245.
216.
Pasqua MR, Tsoukas MA, Haidar A. Changes to insulin requirements over time with semaglutide in adults with type 1 diabetes on insulin pump therapy: a post-hoc analysis of a double-blinded, randomised, crossover trial. Diabetes Obes Metab 2026; 28: 427-433.
217.
Shah VN, Peters AL, Umpierrez GE, et al. Consensus report on glucagon-like peptide-1 receptor agonists as adjunctive treatment for individuals with type 1 diabetes using an automated insulin delivery system. J Diabetes Sci Technol 2025; 19: 191-216.
218.
Malhotra R, Garcia de Paredes J, Smith A, et al. Obesity epidemic and its impact on female fertility: Current understanding and future directions. Cureus 2025; 17: e87283.
219.
Pirkola J, Pouta A, Bloigu A, et al. Risks of overweight and abdominal obesity at age 16 years associated with prenatal exposures to maternal prepregnancy overweight and gestational diabetes mellitus. Diabetes Care 2010; 33: 1115-1121.
220.
Filippi-Arriaga F, Agrawal N, Rodriguez-Martins D, et al. EASO Position Statement: Women with Obesity across the Reproductive Life – Fertility, Preconception, Pregnancy, Postpartum, and Breastfeeding. Obes Facts 2025; 18: 625-639.
221.
Maxwell CV, Shirley R, O’Higgins MC, et al.; on behalf of the FIGO Committee on Impact of Pregnancy on Long-term Health and the FIGO Division of Maternal and Newborn Health. Management of obesity across women’s life course: FIGO Best Practice Advice. Int J Gynecol Obstet 2023; 160 (Suppl 1): 35-49.
222.
Bomba-Opon D, Gutaj P, Kedzia M, et al. Guidelines of the Polish Society of Gynecologists and Obstetricians on the obstetric care of women with obesity. Ginekol Pol 2023; 94: 1011-1029.
223.
Wyckoff JA, Lapolla A, Asias-Dinh BD, et al. Preexisting diabetes and pregnancy: an Endocrine Society and European Society of Endocrinology joint clinical practice guideline. Eur J Endocrinol 2025; 193.
224.
Araszkiewicz A, Borys S, Broncel M, et al. Clinical Recommendations on the Management of Individuals with Diabetes – 2026. Position Statement of Diabetes Poland. Current Topics in Diabetes 2026; 6: 1-172.
225.
Jatin CH, Beniwal SS, Pithalla LB, et al. Managing obstetric and gynecologic complications in obese women: evidence-based strategies for optimizing outcomes and reducing risks. Ann Med Surg 2025; 87: 3586-3595.
226.
Papaetis GS, Kyriacou A. GLP-1 receptor agonists, polycystic ovary syndrome, and reproductive dysfunction: current research and future horizons. Adv Clin Exp Med 2022; 31: 1265-1274.
227.
Claire H, Parker BS, Slattery C, et al. Glucagon-like peptide 1 (GLP-1) receptor agonists’ use during pregnancy: safety data from regulatory clinical trials. J Pharmacol 2025. Available at: https://dom-pubs.onlinelibrary....
228.
Drummond RF, Seif K, Reece A. Glucagon-like peptide-1 receptor agonist use in pregnancy – a review. AJOG 2025; 232: 17-25.
229.
Mandal L, Udby Andersen L, Møller Luef B, et al. Impact of semaglutide exposure on fetal and neonatal outcomes in pregnant women: a systematic review. Eur J Obstet Gynecol Reprod Biol 2026; 317: 114836.
230.
National Institute for Health and Care Excellence (NICE). Tirzepatide: local formulary information. 2024. Available at: https://www.nice.org.uk/guidan....
231.
Dao K, Shechtman S, Weber-Schoendorfer C, et al. Use of GLP1 receptor agonists in early pregnancy and reproductive safety: a multicentre, observational, prospective cohort study based on the databases of six teratology information services. BMJ Open 2024; 14: e083550.
232.
Muller DRP, Stenvers DJ, Malekzadeh A, et al. Effects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and lactation on offspring outcomes: a systematic review of the evidence. Front Endocrinol 2023; 14: 1215356.
233.
American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care 2004; 27: 596-601.
234.
Cooper SJ, Reynolds GP, Barnes T, et al. BAP guidelines on the management of weight gain and metabolic disturbances associated with psychosis and antipsychotic drug treatment. J Psychopharmacol 2016; 30: 717-748.
235.
DeJongh BM. Clinical pearls for the monitoring and treatment of antipsychotic-induced metabolic syndrome. Ment Health Clin 2021; 11: 311-319.
236.
Pillinger T, McCutcheon RA, Vano L, et al. Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia: a systematic review and network meta-analysis. Lancet Psychiatry 2020; 7: 64-77.
237.
American Psychiatric Association. The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry 2021; 178: 868-872.
238.
Carolan A, Hynes-Ryan C, Agarwal SM, et al. Metformin for the prevention of antipsychotic-induced weight gain: guideline development and consensus validation. Schizophr Bull 2025; 51: 1193-1205.
239.
Bak M, Fransen A, Janssen J, et al. Glucagon-like peptide-1 receptor agonists for antipsychotic-induced weight gain: a systematic review and meta-analysis. Acta Psychiatr Scand 2024; 149: 85-96.
240.
Larsen JR, Vedtofte L, Jakobsen MSL, et al. Effect of liraglutide treatment on prediabetes and overweight or obesity in clozapine- or olanzapine-treated patients with schizophrenia spectrum disorder. JAMA Psychiatry 2017; 74: 719-728.
241.
Patino LR, Strawn JR, Adler CM, et al. Exenatide for olanzapine-associated weight gain in severe mental illness: randomized placebo-controlled trial. Diabetes Obes Metab 2025; 27: 1123-1132.
242.
Siskind DJ, Russell AW, Gamble C, et al. Treatment of clozapine-associated obesity and diabetes with exenatide once weekly: a randomized controlled trial. Diabetes Obes Metab 2018; 20: 1050-1055.
243.
Vasiliu O. Therapeutic management of atypical antipsychotic-related metabolic dysfunctions using GLP-1 receptor agonists: a systematic review. Exp Ther Med 2023; 26: 355.
244.
Varghese JS, Goldsmith DR, Cotes RO, et al. Weight change from incretin-based weight loss medications across categories of second-generation antipsychotics. Int J Obes (Lond) 2025; 49: 2544-2548.
245.
Dong K, Wang S, Qu C, et al. Schizophrenia and risk of type 2 diabetes: a systematic review and meta-analysis. Psychoneuroendocrinology 2024; 158: 106115.
246.
Jackson CA, Fleetwood K, Kerssens J, et al. Incidence of type 2 diabetes in people with a history of hospitalization for major mental illness in scotland, 2001-2015: a retrospective cohort study. Diabetes Care 2019; 42: 1879-1885.
247.
Lindekilde N, Rutters F, Eriksson L, et al. Psychiatric disorders as risk factors for type 2 diabetes: an umbrella review. Diabetes Res Clin Pract 2021; 176: 108855.
248.
Janez A, Muzurovic E, Bogdanski P, et al. Modern management of cardiometabolic continuum: from overweight/obesity to prediabetes/type 2 diabetes mellitus. Recommendations from the Eastern and Southern Europe Diabetes and obesity expert group. Diabetes Ther 2024; 15: 1865-1892.
249.
Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric/metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow up of an open-label, single-centre, randomised controlled trial. Lancet 2015; 386: 964-973.
250.
De Luca M, Shikora S, Eisenberg D, et al. Scientific evidence for the updated guidelines on indications for metabolic and bariatric surgery (IFSO/ASMBS). Surg Obes Relat Dis 2024; 20: 991-1025.
251.
Eisenberg D, Shikora SA, Aarts E, et al. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): indications for metabolic and bariatric surgery. Surg Obes Relat Dis 2022; 18: 1345-1356.
252.
Rubino F, Nathan DM, Eckel RH, et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes Care 2016; 39: 861-877.
253.
Pratt JSA, Browne A, Browne NT, et al. ASMBS pediatric metabolic and bariatric surgery guidelines, 2018. Surg Obes Relat Dis 2018; 14: 882-901.
254.
Zaveri H, Surve A, Cottam D, et al. Mid-term 4-year outcomes with single anastomosis duodenal-ileal bypass with sleeve gastrectomy surgery at a single US center. Obes Surg 2018; 28: 3062-3072.
255.
Adams TD, Gress RE, Smith SC, et al. Long term mortality after gastric bypass surgery. N Engl J Med 2007; 357: 753-761.
256.
Arterburn DE, Olsen MK, Smith VA, et al. Association between bariatric surgery and long-term survival. JAMA 2015; 313: 62-70.
257.
Sjostrom L, Lindroos AK, Peltonen M, et al.; Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004; 351: 2683-2693.
258.
Sjostrom L, Narbro K, Sjostrom CD, et al.; Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in swedish obese subjects. N Engl J Med 2007; 357: 741-752.
259.
Schauer PR, Bhatt DL, Kirwan JP, et al.; STAMPEDE Investigators. Bariatric surgery versus intensive medical therapy for diabetes – 5-year outcomes. N Engl J Med 2017; 376: 641-651.
260.
Parmar C, Appel S, Lee L, et al. Choice of bariatric surgery in patients with obesity and type 1 diabetes mellitus? An up-to-date systematic review. Obes Surg 2022; 32: 3992-4006.
261.
Cengiz E, Danne T, Ahmad T, et al. ISPAD clinical practice consensus guidelines 2024: insulin and adjunctive treatments in children and adolescents with diabetes. Horm Res Paediatr 2024; 97: 584-614.
262.
Shah AS, Barrientos-Pérez M, Chang N, et al. ISPAD clinical practice consensus guidelines 2024: type 2 diabetes in children and adolescents. Horm Res Paediatr 2024; 97: 555-583.
263.
Laffel LM, Danne T, Klingensmith GJ, et al. Efficacy and safety of the SGLT2 inhibitor empagliflozin versus placebo and the DPP-4 inhibitor linagliptin versus placebo in young people with type 2 diabetes (DINAMO): a multicentre, randomised, double-blind, parallel group, phase 3 trial. Lancet Diabetes Endocrinol 2023; 11: 169-181.
264.
Tamborlane WV, Barrientos-Pérez M, Fainberg U, et al. Liraglutide in children and adolescents with type 2 diabetes. N Engl J Med 2019; 381: 637-646.
265.
Hannon TS, Chao LC, Barrientos-Pérez M, et al. Efficacy and safety of tirzepatide in children and adolescents with type 2 diabetes (SURPASS-PEDS): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2025; 406: 1484-1496.
266.
Haqq AM, Muehlbauer MJ, Clément K, et al. Setmelanotide in Bardet – Biedl syndrome and Alström syndrome: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Diabetes Endocrinol 2022; 10: 859-868.
267.
Cooper DM, Rothstein MA, Amin A, et al. Unintended consequences of glucagon-like peptide-1 receptor agonist medications in children and adolescents: A call to action. J Clin Transl Sci 2023; 7: e184.
268.
Kelly AS, Auerbach P, Barrientos-Pérez M, et al. A randomized, controlled trial of liraglutide for adolescents with obesity. N Engl J Med 2020; 382: 2117-2128.
269.
Weghuber D, Barrett T, Barrientos-Pérez M, et al. Once-weekly semaglutide in adolescents with obesity. N Engl J Med 2022; 387: 2245-2257.
270.
American Diabetes Association Professional Practice Committee. 13. Older adults: Standards of care in diabetes – 2026. Diabetes Care 2026; 49 (Suppl 1): S277-S296.
271.
Di Vincenzo O, Minnetti M, Baker JL, et al. European Association for the Study of Obesity (EASO) position statement on the diagnosis and management of obesity in older adults. Obes Facts 2025; 1-20.
272.
Narodowy Instytut Zdrowia Publicznego PZH-PIB [National Institute of Public Health PZH-NRI]. Normy żywienia dla populacji Polski [Nutritional norms for the Polish population]. Warsaw: NIZP PZH-PIB; 2024.
273.
Villareal DT, Chode S, Parimi N, et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med 2011; 364: 1218-1229.
274.
Koopmans L, van Oppenraaij S, Heijmans MWF, et al. Dietary protein intake and distribution patterns in community-dwelling older adults. Clin Nutr 2025; 47: 177-184.
275.
Mozaffarian D, Agarwal M, Aggarwal M, et al. Nutritional priorities to support GLP-1 therapy for obesity. Am J Clin Nutr 2025; 122: 344-367.
276.
Prado CM, Batsis JA, Donini LM, et al. Sarcopenic obesity in older adults: a clinical overview. Nat Rev Endocrinol 2024; 20: 261-277.
277.
Sievenpiper JL, Ard J, Blüher M, et al. Nutritional and lifestyle supportive care recommendations for management of obesity with GLP-1-based therapies. Obesity Pillars 2026; 17: 100228.
278.
Villareal DT, Aguirre L, Gurney AB, et al. Aerobic or resistance exercise, or both, in dieting obese older adults. N Engl J Med 2017; 376: 1943-1955.
279.
Narodowy Program Zdrowia na lata 2021-2025 [National Health Programme for the years 2021-2025]. Available at: https://www.gov.pl/web/mswia/n....
280.
Knowler WC, Doherty L, Edelstein SL, et al.; DPP/DPPOS Research Group. Long-term effects and effect heterogeneity of lifestyle and metformin interventions on type 2 diabetes incidence over 21 years in the US Diabetes Prevention Program randomised clinical trial. Lancet Diabetes Endocrinol 2025; 13: 469-481.
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