Diabesity – the new pandemic
We are in the midst of a pandemic and most of us do not even know it!
The rising prevalence of obesity has led to a simultaneous increase in the prevalence of type 2 diabetes, and the term “diabesity” has been used to describe those living with type 2 diabetes and obesity. According to the World Health Organisation (WHO), worldwide obesity has nearly tripled since 1975. There are now (2016 data) 1.9 billion adults overweight, with over 650 million being obese (Body Mass Index >30 kg/m2). Around 463 million adults around the world have diabetes and the number is rising. An overweight person with type 2 diabetes has a reduced life expectancy, as well as reduced quality of life. What can be done to tackle the pandemic of diabesity?
Diabetes has almost become so common that we no longer pay attention to the serious risks the chronic disease can pose. If you have diabesity, that is if you have type 2 diabetes and are overweight or obese, you have an even greater risk of stroke, blindness, heart attack, kidney failure or amputation. While the risks are serious, the disease can be managed and possibly ‘reversed’ (put into remission) with individualised therapy.
If you are overweight or obese, you have a greater risk of developing type 2 diabetes. Obesity is when you have a body mass index (BMI) greater than 30. Your BMI is an estimate of your body fat and is calculated by dividing your weight (in kilograms) by your height (in metres) and then dividing that answer by your height again. Between 80 to 90 per cent of people with type 2 diabetes are overweight or obese.
Obesity is a chronic disease with many complications, including type 2 diabetes. Many patients with type 2 diabetes remain undiagnosed. It is estimated that around 500,000 people in Australia are undiagnosed. It is important to see your doctor for a diabetes risk screen, especially if you are overweight or obese.
Weight matters when it comes to diabetes. When the body has excess fat, especially in muscle and adipose tissue, it leads to insulin resistance. Insulin is the hormone that enables glucose to enter cells. When insulin resistance occurs, the pancreas kicks in and produces more insulin to try and manage blood glucose levels. The body’s ineffective use of insulin results in that person developing type 2 diabetes.
While the most effective treatment for diabesity is bariatric surgery, undergoing such treatment is expensive and may result in surgical complications. Most people with diabesity require a comprehensive treatment strategy, which a team of health professionals should develop. A doctor is only one member of that team, other team members may include a dietitian, a diabetes educator, an exercise physiologist and a health psychologist. This team can develop a strategy that focuses on lifestyle modifications, such as a healthy diet and increased physical activity, medications and, if applicable, identification and treatment of any underlying anxiety or depression. Healthcare professionals should also be spending time explaining to their patients about how this is a chronic disease, not a lifestyle problem.
While diabesity has no cure, proper management of the disease can cause it to go into remission. Losing weight can also prevent or delay the progression of type 2 diabetes by up to 60 per cent, in those with risk factors for diabetes. If a person is overweight or obese, modifying their lifestyle is the best thing they can do to reduce their risk of developing type 2 diabetes. This means weight reduction through a healthy diet and increased physical activity. Avoid becoming a statistic in the diabesity pandemic and take positive steps towards a healthy lifestyle.
IDF Diabetes Atlas 9th edition (2019)
JCU Brighter (2017) Tackling the weighty issue of diabesity
Rasalam et al., (2016) Tackling diabesity: Weight management issues for people with type 2 diabetes
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