How does obesity link to diabetes?

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In September 2006, a journal called Critical Care published the results of a study on diabetes and obesity. The study revealed that diabetes – more than obesity on its own – was responsible for the increased risk of death among the obese. To make that slightly less convoluted, if you have diabetes, you increase your chances of developing a critical illness and/or dying early; merely being obese does not make you vulnerable. Yes, obese individuals do experience certain physical problems, but these are as likely to afflict the non-obese, is what the study seeks to establish.

The researchers, from the University of Kentucky’s Chandler Hospital and Emory University School of Medicine, reviewed the health of a 15,000-strong sample group, the members of which had originally been studied 20 years ago. They looked for the presence of diabetes (Type 1 and Type 2), analyzed the body mass indices and reviewed the members’ histories of critical illness (such as organ failure) and mortality.

The research findings revealed that the obese are not at increased risk of organ failure or premature death if they do not have diabetes. Correspondingly, patients with diabetes were found to be three times more likely to suffer from organ failure and die from it – or any other cause – than non-diabetics, regardless of their body mass index. Finally, the authors concluded that obesity itself might not intrinsically lead to what they refer to as “poor outcomes”.

However, if you thought that all this means you could go ahead and pile on the adipose, beware. Among other things, the study has also revealed that those who are obese are more likely to develop diabetes than the non-obese. In fact, a highly disturbing recent trend has been the increase of Type 2 diabetes among teens and even pre-teens, in extreme cases.

Dr Nicola Sexton M.D., 59, a consultant endocrinologist based in Akron, Ohio, says she is treating more teenagers for diabetes now than at any time of her long career. “Sadly, most of these children are obese, and I firmly believe increasing teenage diabetes is attributable to increasing childhood obesity. As recently as 10 years ago, I had virtually no patients under 30. Today, at least seven or eight percent of the patients I see are under 19, and that has to be cause for alarm,” Dr Sexton says.

Living with diabetes

Nutritionist Harry Neville says “lifestyle shifts” are the best way to deal with diabetes. “If diabetes runs in your family, you are a high-risk case and the only way to keep the problem under control is by modifying your lifestyle,” he explains. “But the problem with diabetes is that we still don’t know exactly what brings it on.”

Well, we know that those with a family history of diabetes are about 25% likely to develop the disease, but we also know that diet is a major contributor. “Most people do not eat a balanced diet,” says Harry. “The idea behind a balanced diet is that it produces enough for the body to perform vital functions. So if you don’t eat the right food, the pancreas does not secrete enough insulin. So cut out the carbohydrates and fats, and concentrate on vegetable proteins and vitamins.”

Heredity, food, obesity…the three main causes of diabetes have company in the form of stress, and, in rare cases, a viral attack that affects the pancreas. And the only way to combat these is to eat the right foods, get adequate exercise and conduct regular health check-ups that can warn of impending diabetes. As Dr Sexton says, “Living with diabetes is not easy, but you can stay ahead most of the time given you follow a certain lifestyle.”

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