Review Reports

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Overall well-written, but caveats noted. Please find attached recommended changes. 

Comments for author File: Comments.pdf

Comments on the Quality of English Language

Author Response

Overall well-written, but caveats noted. Please find attached recommended changes.

It is overall, a well-written review. However, the major caveat is that the authors have looked at two pathologies independently whereas the title suggests a very high degree of codependency. Also, diabetes in the title seems very generic whereas throughout the paper the authors have focused only on T2D

Dear reviewer,

Thank you very much for your insightful comments on our paper. We appreciate the time and effort that you have dedicated to providing your valuable feedback on our manuscript. We have been able to incorporate the suggested changes and we have highlighted them within the manuscript with track changes.

We completely agree with your observation about the Type 2 Diabetes (T2D). Throughout the paper, the focus is on diabetes in general, not just T2D. We identified and corrected three instances where we mistakenly used 'T2D' when 'diabetes' was the intended term, ensuring the information applies to both type 1 and type 2. However, type 1 diabetes (T1D) is also specifically discussed as a distinct entity, particularly when addressing autoantibodies and new insulin development. We believe this distinction remains relevant within the scope of the review, as these aspects are not applicable to T2D in the same way. The manuscript was updated accordingly.

Additionally, a new section was added to explore the interconnected nature of obesity and T2D, and how their management can be unified through shared therapies.

 

What is strongly recommended is a detailed section (after the reviews of independent conditions) to cover a detailed lit. review for patients having Obesity AND T2D comorbidity management (making it in tandem with all aspects of this review - current literature, advancements treatments etc).

A new section (5.  Managing Obesity and Type 2 Diabetes) was added to the manuscript.

 

A flowchart to explain the inclusion and exclusion criteria is mandated (based on literature search, how many papers relevant to this work were analyzed/studied?

The revised manuscript now includes a flowchart to illustrate the selection process of the reviewed literature (Figure 1).

 

Please include a figure to summarize section 3.1

We have added a new figure (Figure 2) to the manuscript that visually summarizes the key points of section 3.1.

 

Biomarkers

This section is very generic. Please expand on what are some of the known biomarkers which have translated into therapies and some of the potential ones currently under different levels of clinical trials.

Following your suggestions, the biomarkers section has been revised and strengthened.

 

As with section 3.1, Please include a figure to summarize section 3.2

A new illustration (Figure 3) is now included in the manuscript, summarizing the content of section 3.2.

Reviewer 2 Report

Comments and Suggestions for Authors

I commend the authors on the completion of this manuscript. It is on an important topic. They present a synthetic and clear narrative review based on latest research and innovations about new diagnostic and treatment approaches for obesity and diabetes. I only have some minor concerns highlighted below.

 

Specific Comments

Methods

Line 112. Please, clarify the designated date range.

 

3. Diagnostic advancements

Line 145. Could you add some reference including data about the measurement technical error of the BIA, or about reliability values? 

Line 200. Please explain the acronym in anti-GAD antibodies. 

 

4. Treatment advancements

Line 241. Please, could you add a little more information about SADI-S surgical procedure? 

Line 385. You can remove one point: “[86,87]..”

Line 480. Please could you add a little more information explaining “Ultrasound Neuromodulation with liver-focused peripheral focused ultrasound stimulation (pFUS)” procedure? 

Author Response

I commend the authors on the completion of this manuscript. It is on an important topic. They present a synthetic and clear narrative review based on latest research and innovations about new diagnostic and treatment approaches for obesity and diabetes. I only have some minor concerns highlighted below.

 

Dear reviewer,

Thank you very much for your insightful comments on our paper. We appreciate the time and effort that you have dedicated to providing your valuable feedback on our manuscript. We have been able to incorporate the suggested changes and we have highlighted them within the manuscript with track changes.

 

Line 112. Please, clarify the designated date range.

Our review primarily focuses on articles published between January 2010 and July 2024. While a few pre-2010 references provide historical context, the manuscript has been updated, and a flowchart to illustrate the selection process of the reviewed literature is now included.

 

3. Diagnostic advancements

Line 145. Could you add some reference including data about the measurement technical error of the BIA, or about reliability values? 

We have addressed this by incorporating additional details that discuss the drawbacks of BIA measurements. This information is now included in the revised manuscript.

 

Line 200. Please explain the acronym in anti-GAD antibodies. 

The manuscript was updated accordingly.

 

 

4. Treatment advancements

Line 241. Please, could you add a little more information about SADI-S surgical procedure? 

We included more information about SADI-S as suggested.

 

 

Line 385. You can remove one point: “[86,87]..”

The manuscript was updated accordingly.

 

 

Line 480. Please could you add a little more information explaining “Ultrasound Neuromodulation with liver-focused peripheral focused ultrasound stimulation (pFUS)” procedure? 

We have addressed your request by adding a new paragraph explaining pFUS. This information is now included in the revised manuscript.

Reviewer 3 Report

Comments and Suggestions for Authors

The current study presents a literature review on the progress made in managing obesity and diabetes. Please address the following issues.

1. The primary objective of the present paper was not clearly introduced.

2. The scientific data seems insufficient to support your perspective. Please compare each using established techniques such as bibliometrics and other recognized methods.

3. Statistical significance is necessary for each view.

4. The progress presents an optimistic picture. What proof is available?

5. The concept of novelty was not well explained. Kindly provide this specific component along with any additional ones.

6. Limitations should be properly rephrased.

Comments on the Quality of English Language

It seems better to check through the professional editing service.

Author Response

The current study presents a literature review on the progress made in managing obesity and diabetes. Please address the following issues.

Dear reviewer,

Thank you very much for your insightful comments on our paper. We appreciate the time and effort that you have dedicated to providing your valuable feedback on our manuscript. We have been able to incorporate the suggested changes and we have highlighted them within the manuscript with track changes.

1. The primary objective of the present paper was not clearly introduced.

The Introduction section has been revised to provide a more focused and well-defined statement of the review's objectives.

2. The scientific data seems insufficient to support your perspective. Please compare each using established techniques such as bibliometrics and other recognized methods.

In navigating the extensive body of published research in this field, alongside scientific databases, we utilized Connected Paper, a tool for bibliographic analysis. This facilitated efficient identification of pertinent studies, prioritizing those with higher citation counts and recent publication dates.

It's important to clarify that this review focuses on synthesizing existing literature, not conducting a full-fledged bibliometric analysis, systematic review, or meta-analysis. While those methodologies involve even more rigorous evaluation methods, our goal here was to provide a comprehensive overview of recent advancements.

We have included additional citations from relevant studies to enhance the scientific foundation of this review. We believe this ensures that the literature chosen provides valuable insights into the field.

3. Statistical significance is necessary for each view.

We would like to clarify that our manuscript is a literature review. Our objective was to present the findings of various studies in a concise and accessible manner, without performing any new statistical analyses ourselves. Could you please provide further clarification on your suggestion for including statistical significance? We are eager to understand your perspective and make any necessary adjustments to enhance the clarity and impact of our review.

4. The progress presents an optimistic picture. What proof is available?

Compared to the innovation rate before e.g., 2010, the pace and scope of advancements in the management of obesity and diabetes have accelerated markedly. This rapid development is evidenced by the array of new diagnostic tools, treatment methods, and technological integrations highlighted in our review. Over the past decade, there has been a notable increase in the development and market introduction of new technologies for diabetes and obesity management. For instance, Continuous Glucose Monitoring (CGM) systems and closed-loop insulin delivery systems, have made significant strides since 2010. These technologies represent a considerable leap forward in providing continuous and precise glucose monitoring and insulin administration.

Additionally, the integration of artificial intelligence and machine learning in diabetes management has accelerated in recent years, offering advanced decision support systems that enhance patient care.

These innovations collectively highlight the rapid pace of technological advancement post-2010, far surpassing the innovation rate seen before this period.

The Conclusion section has been revised to offer a more comprehensive and insightful summary of the key findings.

5. The concept of novelty was not well explained. Kindly provide this specific component along with any additional ones.

The Introduction has been revised to highlight the focus on recent advancements and the potential of emerging technologies in the field.

6. Limitations should be properly rephrased.

The Limitations section has been revised.

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

It has been revised according to concerns.