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Obesity & Diabetes
It is a well documented fact that the world is facing a global obesity epidemic. While causes of obesity may vary, current lifestyles, which discourage physical activity and promote unhealthy eating, undoubtedly contribute to it. Unfortunately, while obesity itself is hard to live with, it also causes several co-morbidities, of which diabetes is one of the most crucial one. Dr Muffazal Lakdawala explains the relation between diabetes and obesity and suggests ways of combating it.
Research shows that Obesity exposes a person's susceptibility to the most common form of diabetes – Type 2 Diabetes. Approximately 80% of individuals with type 2 diabetes are obese. The risk of developing diabetes increases with the severity of obesity, duration of obesity, and central distribution of body fat.
Type 2 Diabetes
Recent studies suggest that even a modest gain in weight increase susceptibility to diabetes especially for those who are genetically or physiologically vulnerable. In fact, around 90% of Type 2 diabetes is attributed to excess weight, with the risk rising progressively from a body mass index of 21 kg/m2. Sedentary lifestyles in such cases magnify the impact of weight gain and increase their immunity to insulin. This condition is called Insulin resistance (IR), where the effectiveness of insulin in transporting glucose (sugar) into cells is diminished. Since fat cells are more insulin resistant than muscle cells; one may safely claim that obesity is one of the most important causes of IR.
The pancreas initially responds to IR by producing more insulin. As long as the pancreas can produce enough insulin to overcome this resistance, blood glucose levels remain normal. This IR state (characterized by normal blood glucose levels and high insulin levels) can last years. Once the pancreas can no longer keep up with producing high levels of insulin, blood glucose levels begin to rise, resulting in type 2 diabetes.
Obesity, Diabetes & Children
Initially obesity was limited to the adult population. However in the last two decades, the incidence of obesity among children has risen by nearly 50 percent. What is even more unfortunate is that along with obesity, the number of children suffering from diabetes, particularly type-2 diabetes has also increased. Usually Type-II diabetes or starts after the age of 30. However, recent studies indicate that children suffering from obesity are already becoming type-II diabetics and by adulthood would definitely join the population of people suffering from this disease.
What is alarming is that this appears to be a global trend. In the USA, nearly 30 per cent of diabetics below the age of 20 suffer from type-II diabetes. In Japan, more than half of diabetic children suffer from this disease. India in turn has the largest and fastest growing diabetic population in the world. There are around 33 million diabetes patients, in India today and over the past three decades, the number of affected patients has increased 10 times.
However diabetes is not the only issue related to childhood obesity. Obese children may have greater difficulty with high blood pressure, high cholesterol levels, orthopedic problems, sleeping habits, as well as low self-esteem and poor peer relationships. In addition, Obesity can complicate the treatment and management of diabetes and can even lead to the body developing a resistance to insulin.
The fatal combination of obesity and diabetes is often also a cause of adverse pregnancy outcomes, such as primary cesarean delivery and low birth weight. About three to five percent of all pregnant women develop gestational which is caused by the changes in hormones in your body during pregnancy. Factors that have been identified as increasing the risk for gestational diabetes are obesity, a family history of diabetes, having given birth to a very large infant previously, having had a stillbirth or a child with a birth defect. Although this type of diabetes disappears when the baby is born, some women who have gestational diabetes go on to develop diabetes when they get older.
Prevention & Cure
Prevention is better than cure, o ne of the best ways to combat diabetes ari sing out of obesity is to prevent weight gain, increase activity levels and work towards small amounts of weight loss. It has been seen that even a modest loss in weight improves insulin sensitivity and glycemic control. Even weight loss as small as 2.5% has proved to have a beneficial impact on diabetes.
Surgically-induced weight loss is documented to have shown improvement in co-morbidities like Type 2 diabetes and hypertension. In fact, surgically-induced weight loss has yielded superior results than various medical therapies.
Patients have witnessed a dramatic improvement in their insulin requirements and no longer require insulin as early as 48-72 hours post surgery up to 1 year in different of bariatric surgery.
Bariatric surgery is one of the best forms of treating diabetes and hypertension.