At the start of this century, 171 million people were estimated to have type 2 diabetes, and this figure is expected to increase to 360 million by 2030. Overweight and obesity are defined by an excess accumulation of adipose tissue to an extent that impairs both physical and psychosocial health and well-being.
According to Dr. Apsia Ruhi Specialist Endocrinologist at Zulekha Hospital Dubai, obesity is considered a health disaster in both developed and developing countries and is escalating significantly in many nations worldwide. Below she shares some of her insights into the disease.
Causes and Symptoms
Obesity is linked to many medical, psychological, and social conditions, causing increased rates of cardiovascular and renal disease, certain cancers, arthritis, hypertension, sleep apnea , the most devastating of which may be type 2 diabetes.
Both type 2 diabetes and obesity are associated with insulin resistance. Most obese individuals, despite being insulin resistant, do not develop hyperglycaemia. Pancreatic β-cells of the islet of Langerhans release adequate amounts of insulin that are sufficient to overcome insulin level reductions under normal circumstances, thus maintaining normal glucose tolerance.
The Studies
The 1st study was the Diabetes Prevention Program to identify individuals who were at risk for developing diabetes because of elevated fasting plasma glucose or impaired glucose tolerance levels and to determine if metformin or an intensive lifestyle intervention could delay or prevent the onset of diabetes. More than 3,000 individuals with prediabetes were randomized to receive placebo, metformin, or a 16-session lifestyle-modification program.
The 2nd study that examined lifestyle treatment of diabetes and obesity is the Look AHEAD Trial to determine the effect of intentional weight loss on cardiovascular risk factors in individuals with diabetes. Approximately 5,100 individuals with type 2 diabetes and an elevated BMI were randomized.
Top tips on Diabetes Prevention
- Increase intake of Low glycemic index foods with high protein, low carbohydrates, low fats as of Mediterranean diet.
- Weight Loss Goals Weight loss of 5–10% of baseline body weight is recommended. Prevention of diabetes can be accomplished through a 7% weight loss through intensive lifestyle interventions that include caloric reduction and approximately 30 min of daily moderate physical activity.
- The best treatment for diabetes is prevention.
5 A’s model for behaviour change and weight management
| 1.ASSESS
|
Assess degree of obesity and metabolic risk factors present at baseline .
Assess persons readiness and ability to make change. |
| 2. ADVICE | Advice about increased risk of cardiovascular diseases with excess adiposity.. Advice regarding health benefits of weight loss and lifestyle change |
| 3. AGREE | Agree for quantifiable and achievable weight loss goals 5% in 6 months duration. |
| 4. ASSIST | Assist in making a weight management strategy |
| 5. ARRANGE | Arrange follow up to create structure for accountability and feedback on progress. |
Diabetes and obesity are chronic disorders that are on the rise worldwide. Body mass index has a strong relationship to diabetes and insulin resistance. In an obese individual, the amount of NEFA, glycerol, hormones, cytokines, proinflammatory substances, and other substances that are involved in the development of insulin resistance are increased.
Insulin resistance with impairment of β-cell function leads to the development of diabetes. NEFA is a cornerstone in the development of insulin resistance and in the impairment of β-cell function. New approaches in managing and preventing diabetes in obese individuals must be studied and investigated.
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