Diabetes is a global health problem of enormous magnitude, especially in newly industrialized and developing nations. The last 4 decades have seen mounting epidemics of type 2 diabetes in traditional living populations as their lifestyle has changed to a modern “Western” pattern, a process associated with the globalization of the world.
Diabetes is one of the most costly and burdensome chronic diseases of our time. With increasing longevity, changes in demographic age distributions, rising urbanization, obesity epidemic and further modernization, the number of people with type 2 diabetes will likely to continue to increase.
Type 2 diabetes will constitute a major public health problem in nearly every nation through the corresponding burden of complications and premature mortality. The complications resulting from the disease are a significant and are associated with the damage or failure of various organs such as the eyes, kidneys, and nerves. Individuals with type 2 diabetes are also at a significantly higher risk of death from coronary heart disease, peripheral vascular disease, and stroke.
Now, we all know that the epidemic of diabetes in large part derives from the increase in obesity that has occurred. We also know that genetics are a major risk factor for type 2 diabetes. Nevertheless, in the past decade, our genetics have not changed. What has changed is our lifestyle
Obesity substantially increases cardiometabolic and biomechanical disorders with significant increased risk for several cancers. Yet perhaps one of the most visible and serious public health consequences of obesity is type 2 diabetes and it’s many associated complications.
The relationship of obesity and type 2 diabetes is well established. Numerous studies demonstrate that overweight and obese individuals are at an increased risk of developing type 2 Diabetes. In fact, evidence shows that body mass index (BMI), is directlyand continuously related to the risk of type 2 diabetes. According to data from the Nurses’ Health Study, the risk of diabetes increased 5-fold in women with a BMI of 25; this risk increased 28-fold for those with a BMI of 30, and 93-fold for those with a BMI greater than 35 kg/m2. Men have a similar, yet smaller, increased risk; those with a BMI greater than 35 kg/m2 have a 42-fold increased risk of developing diabetes. In addition, there is evidence that the duration of obesity is directly related to the risk of diabetes. Obesity is expected to surpass smoking as the number one preventable cause of death.
Given these facts, the link between diabetes and obesity is so strong that a new word has been coined (Diabesity) to emphasize the strong association between largely preventable lifestyle-related diseases.
Treating obesity in patients with diabetes is particularly challenging because it is more difficult for individuals with diabetes to lose weight compared with those without it. A study showed that patients with type 2 diabetes had a more difficult time losing weight compared with controls. Still, even modest weight loss in patients with type 2 diabetes improves glycemic control, insulin sensitivity, and cardiovascular risk factors. Another study conducted a 10-year prospective cohort study to examine the effect of weight gain and weight loss on type 2 diabetes in overweight adults without diabetes. Relative to overweight people with stable weight, each kg of weight gained annually over 10 years was associated with a 49% increase in risk of developing diabetes. Conversely, each kg of weight lost annually over 10 years was associated with a 33% lower risk of diabetes in the subsequent 10 years.
The escalating co-epidemics of obesity and type 2 diabetes (Diabesity) and their associated complications have focused greater attention on weight loss to delay or prevent as well as manage the disease.