Dr Shyni Babu talks about weight gain and Diabetes


Like diabetes, obesity has also increased to epidemic proportions in several parts of the world. World Health Organisation estimates that 39% of the global population is overweight and 13% are obese. In India also, 19% to 40% have obesity, according to different studies. The main factors for the rise in obesity are high-calorie/high-fat food intake, insufficient physical activity, and a more sedentary lifestyle.1,2

Obesity and diabetes

Weight gain at a younger age increases the risk of developing type 1 diabetes. The growing number of children and adults with type 2 diabetes (T2D) is also related to the obesity epidemic.3 So, those who are overweight or obese in childhood or adolescence are likely to be affected by diabetes later in their life.4

Besides, obesity also increases the risk of complications of diabetes, such as retinopathy, nephropathy, and heart disease.4,6 Obese individuals also have a 7 times higher risk of death.2

What causes diabetes in overweight/obese individuals?

Both T2D and obesity are associated with insulin resistance.1 Insulin resistance is when more than normal amounts of insulin are required for normal blood glucose control.5 Insulin resistance is more often observed in obese children with high weight, height, and waist circumference.6

Additionally, both insulin sensitivity and pancreatic beta-cell function reduce in obese patients.3 Obesity combined with insulin deficiency leads to the development of type 2 diabetes.6

Weight reduction for Diabetes control

Reduction in body weight has a positive effect on glucose control in patients with diabetes, with improvement in insulin resistance. Importantly, the incidence of new cases of T2D in high-risk individuals can be decreased by following a healthy lifestyle for weight control.5 Awareness about healthy diet, physical activity, and lifestyle modification is very important in obese adolescents, which can help in lowering insulin resistance, improving glucose control, and also preventing T2D in those who are at risk.6

A 5–10% reduction in body weight is recommended as the initial goal of treatment in overweight/obese patients with diabetes. Importantly, a 7% reduction in body weight in individuals with prediabetes can prevent the development of diabetes.7

Diabetes linked to obesity is rapidly growing nowadays. Thus, it is important to consider combined treatment strategies for weight management and diabetes for favorable outcomes.2 Patients must follow lifestyle modifications, including diet and physical exercise, to achieve recommended weight loss.

References:

  1. Venkatrao M, Nagarathna R, Majumdar V, et al. Prevalence of obesity in India and its neurological implications: A multifactor analysis of a nationwide cross-sectional study. Ann Neurosci. 2020;27(3-4):153-61.
  2. Leitner DR, Frühbeck G, Yumuk V, et al. Obesity and type 2 diabetes: Two diseases needing combined treatment strategies – EASO can lead the way. Obes Facts. 2017;10(5):483-492.
  3. Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism linking diabetes mellitus and obesity. Diabetes Metab Syndr Obes. 2014;7:587-91.
  4. Karin A, Jon E, Martin A, et al. Body mass index in adolescence, risk of type 2 diabetes and associated complications: A nationwide cohort study of men. E Clinical Medicine. 2022;46:101356.
  5. Riobó Serván P. Obesity and diabetes. Nutr Hosp. 2013;28 Suppl 5:138-43.
  6. Chobot A, Górowska-Kowolik K, Sokołowska M, et al. Obesity and diabetes-Not only a simple link between two epidemics. Diabetes Metab Res Rev. 2018;34(7):e3042.
  7. Bramante CT, Lee CJ, Gudzune KA. Treatment of obesity in patients with diabetes. Diabetes Spectr. 2017;30(4):237-43.

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