The Center of Excellence for Metabolic Health is born at the Irccs San Raffaele hospital in Milan. A multidisciplinary path for 360-degree management – from screening to diagnosis and tailor-made treatment – of patients with overweight-obesity and/or other metabolic diseases such as type 2 diabetes, dyslipidemia, arterial hypertension and metabolic liver diseases . Syndromes which in Italy and around the world are experiencing a “continuous expansion, which has become a pandemic”, as the San Donato Group explains, “frequently present in multiple associations and responsible for high cardiovascular risk and early mortality”.
In addition to an epidemiological context in which 4 out of 10 Italian adults are overweight, 3 of whom are overweight and 1 obese (Istat BES 2023 Report), the new center is also inspired by innovations on the therapeutic front. In fact, in the last decade a new class of drugs called incretins and more specifically Glp-1 agonists have emerged – underline the San Raffaele experts – which during clinical trials have demonstrated unprecedented results in combating metabolic diseases. Drugs such as semaglutide, which through innovative mechanisms of action and maintaining a very high safety profile have demonstrated effectiveness in the treatment of diabetes 2, obesity and metabolic liver diseases. Treatments associated, for the first time, with a significant reduction in cardiovascular risk, with evident cardiac and renal protective effects. Therapies deemed “revolutionary” due to “the enormous impact that a more extensive use could have on public health”, also from a “social and economic” point of view.
Internists, endocrinologists, cardiologists, nutritionists and psychologists already working at San Raffaele will work in the new center. The service “will be accessible to all those who have a BMI (body mass index) equal to or greater than 27, associated or not with other risk factors, who intend to pursue a balanced reduction in body weight”, states Emanuele Bosi, head of Diabetology and Hepatology at San Raffaele and full professor of Internal Medicine at Vita-Salute San Raffaele University. “A personalized therapeutic and monitoring strategy – explains the specialist – will be identified for each patient. The first step will be based on nutritional, physical and lifestyle assessments and recommendations. The second step will contemplate the option of pharmacological therapy, based on the use of new generation Glp-1 drugs, recently available also in Italy. Finally, follow-up visits will be scheduled and personalized based on the characteristics of the patients, involving, in most cases, referral to re-evaluations by general practitioners or, depending on clinical needs, readmission to our centre”.
“Among the principles that contribute to defining the concept of metabolic and overall health of the person of which the San Raffaele hospital intends to promote – specifies Bosi – there is also that of mental health and psychological well-being. Evaluation and psychological support are part of the path offered to the patient, where the need arises or at the request of the interested party, in addition to nutritional consultancy, as a fundamental component of the diagnosis and treatment of our patients”.
The Center of Excellence for Metabolic Health “will be a point of reference for Italian and foreign patients with overweight and obesity problems – declares Federico Esposti, neurophysiologist and operational director of Irccs San Raffaele – offering them a complete diagnostic path, with integrated solutions between nutritional interventions, behavioral education and pharmacological therapies, in order to promote and consolidate optimal metabolic health over time within a balanced lifestyle. An additional objective will be to create a territorial network of doctors who operate in line with the protocols and the training received from the San Raffaele hospital, following patients in the follow-up in order to maximize effectiveness and maintenance of weight loss results, in collaboration with local pharmacies”.
The Irccs San Raffaele hospital in Milan – recalls a note – has always invested great efforts and resources in research in the field of diabetes and related metabolic diseases. Since 2007 it has created the Diabetes Research Institute (DRI), an example of a scientific institute capable of integrating basic research with clinical trials and daily care practice, applying a translational research model with few other examples, even at the international. In the various areas of metabolic diseases, diabetology, obesity, clinical nutrition, eating disorders, hepatology and clinical cardiology, San Raffaele follows between 87 and 94 thousand patients every year, making it not only one of the major Italian centers for the treatment of these pathologies, but also one of the most qualified translational research centres, integrated with many other scientific disciplines and with the teaching activities of the Vita-Salute university. With the addition of this new center of excellence, San Raffaele begins to actively deal with the prevention phase of metabolic syndromes and related pathologies.
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