Early treatment of obesity may prevent diabetes

Obese people run a high risk of developing diabetes; MG Bhat draws a link between the two

-Dr M G Bhat

Persons who are obese or overweight are more likely to suffer from Diabetes. Obesity and Diabetes are inter-linked. However, timely control of Obesity can protect a person away from contracting Diabetes.

Many obese people accumulate fatty acids, glycerol, hormones, cytokines, pro-inflammatory markers and other things involved in development of insulin resistance, thereby increasing the risk of becoming diabetic.

In Diabetes, either insulin is not sufficiently produced by Pancreas in the body or whatever amount is produced does not function properly. Thus, the cells of Pancreas can be impaired causing a lack of control of blood sugar. The role of insulin is to neutralise sugar in blood.

The development of diabetes becomes all the more inevitable if failure of Pancreas cells is accompanied by insulin resistance. Weight gain and body mass lead to rising incidence of type 1 and type 2 diabetes.

Therefore, the best approach to tackle Obesity and Diabetes would be to control weight gain in an obese person. The onset of diabetes in an obese person can be deferred or delayed to a certain extent possible, if not totally prevented.

Type 1 diabetes occurs mostly in children but it can sometimes also appear in adult age groups particularly in those who are in their late thirties or early forties.

In Type 2 diabetes, the amount of insulin produced from Pancreatic cells in a diabetic person is generally low, combined with insulin resistance. In such cases, insulin resistance leads to elevated fatty acids in the plasma, causing decreased glucose transport into muscle cells, combined with increased fat breakdown leading to elevated hepatic glucose production.

An obese person has some kind of insulin resistance but diabetes occurs in those individuals who do not have sufficient insulin production to match the degree of insulin resistance. In such cases, insulin production may be high but not enough to normalise the sugar levels. Besides, diabetes can lead to cardiovascular problems if blood sugar remains uncontrolled.

Obesity, coupled with Diabetes, is considered as a serious health hazard in developed countries and Developing nations. Obesity among children is a major cause of Type 1 Diabetes which erupts due to genetic or environmental factors.

Obese persons go for bariatric surgery like Gastric Bypass, where the weight loss is achieved by reducing the size of stomach through removal of portion of stomach and re-routing the small intestine to a small stomach pouch. In my opinion, bariatric surgery should only be an extreme step to be recommended by a qualified doctor/surgeon, after evaluating and exhausting all initial protocols of diet, exercise and medication.

Obesity can be linked to several medical, psychological and social conditions and can trigger type 2 diabetes in an obese person. But by controlling weight, an obese person can generally keep away Diabetes. Most of the times, obesity can be controlled by reduced food intake, nutritious diet, regular physical activity and medicines.

Contributed by: Dr M G Bhat, Obesity Surgeon, Apollo Spectra and Manipal Hospital.

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