Obesity: The "vestibule" of type 2 diabetes

Diabetes mellitus is today an important global health problem with an ever-increasing prevalence.

It is a condition where the body is unable to effectively use the glucose we get from food to convert it into energy. It is characterized by an increase in the concentration of sugar in the blood (hyperglycemia) and a disturbance of glucose metabolism, either as a result of decreased secretion of insulin from the pancreas, or due to a decrease in the sensitivity of the body's cells to insulin.

Obesity occupies the most important place among the causes blamed for the worldwide epidemiological dimensions of type 2 diabetes. It is defined by the World Health Organization (WHO) based on the Body Mass Index (BMI) which is the reason of weight in kilograms by height in meters squared.

Its incidence is increasing worldwide at a rapid rate, with the main responsible factors being the change in eating habits characterized by a large increase in the intake of fats and easily absorbable carbohydrates combined with a decrease in physical activity. Of people with type 2 diabetes, about 90% are classified as overweight or obese. The risk of its occurrence is twice in overweight people, five times in obese and ten times in morbidly obese people compared to normal weight people of the same age.

However, in addition to the BMI value, there are three factors related to weight that contribute to the manifestation of type 2 diabetes. These are the increase in body weight over time, the duration of obesity and the distribution of fat in the body.

It is noteworthy, however, that obesity, especially of the central type (accumulation of fat mainly in the trunk) not only increases the risk of type 2 diabetes, but also contributes to the exacerbation of the metabolic disorders that accompany it, such as dyslipidemia, hyperinsulinemia and hypertension, resulting in the coexistence of these conditions leads to increased morbidity and mortality from cardiovascular disease.

Coping

The effective treatment of obesity plays a central role both in treating, preventing or slowing the onset of type 2 diabetes, as well as in the good regulation and especially the reduction of cardiovascular risk when the disease is diagnosed.

Medication is given if dietary guidelines and increased physical activity for a period of 3-6 months do not achieve the goal of losing 5 – 10% body weight.

In general, reducing obesity by any means leads to a reduction in the likelihood of developing type 2 diabetes. Weight loss in these individuals results in better blood sugar regulation, up to the point of complete remission of the disease, as well as a reduction in mortality from cardiovascular diseases.

Angelos Klitsas

Specialist pathologist-diabetologist

National Resistance 74 & Aiantos, Building 1 (Votsi)

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