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Diabesity: Giving a name to the abusive relationship between obesity and diabetes

Diabesity: Giving a name to the abusive relationship between obesity and diabetes

By Dr. Gena Vennikandam

Ever hear the biblical proverb, “If you find honey, eat just enough.”? These words to the wise warn of overindulgence and gluttony, which can lead to illness. Unfortunately, for many, this warning goes without heed, and obesity that leads to diabetes is becoming commonplace.

Diabetes was the seventh leading cause of death in the United States in 2010. As of 2012, 29.1 million people in the United States had diabetes, according to the National Diabetes Statistics Report for 2014. And the numbers are rising.

According to the Centers for Disease Control and Prevention, 40 percent of Americans will develop diabetes—that’s two out of every five of us.

Diabetes is a metabolic disease, defined by hyperglycemia, or high blood sugar. Type 1 diabetes, in which the pancreas does not produce insulin, is also referred to as insulin dependent diabetes or juvenile diabetes (though it may occur in adults). It has no definite cause, though there appears to be an autoimmune effect as well as a genetic predisposition. There are no preventive measures.

Type 2 diabetes, however, is directly related to lifestyle—and is very preventable. About 90 to 95 percent of people with diabetes have Type 2 diabetes, in which the body does not use insulin properly. Obesity is the leading cause. There’s even an industry term for the relationship: Diabesity.

Alarmingly, diabesity is now affecting children. “It was actually unheard of 20 years ago to get Type 2 diabetes in a kid. But because people are increasing rapidly in size and gaining so much weight, children with Type 2 diabetes is a far bigger issue,” says Vidhya Viswanathan, MD, pediatric endocrinologist at Advocate Children’s Hospital. “People don’t realize the complications of gaining too much weight.”

As the diabesity epidemic rises, prevention is paramount. Achieving a normal body weight through physical exercise and a well-balanced, healthy diet—in addition to cessation of bad habits such as smoking—can prevent many cases of Type 2 diabetes.

What’s also important to understand is that diabetes is the catalyst to a host of health problems. It is strongly associated with kidney failure, high blood pressure, heart disease, stroke, peripheral artery disease and neuropathy (nerve damage resulting in weakness, numbness and pain). It can contribute to the development of ulcers and gangrene, often leading to the need for amputations. Other conditions include erectile dysfunction, liver disease, gum disease, complications during pregnancy and depression, to name a few.

Diabetes also takes an emotional toll on those affected, putting people at an increased risk for depression. This condition impacts their everyday lives and can be emotionally and psychologically challenging for them as well as their loved ones.

Despite the damage it’s doing to us, so many still underestimate the seriousness of this debilitating condition.

“We don’t take diabetes seriously because we don’t take our diets seriously. We overeat in America,” says Cedric Coleman, MD, assistant professor of medicine at Rush University Medical Center. “We have to get a better grasp of physical education and healthy eating at an early age.”

Because the whole body is at risk for diabetes complications, the whole body needs to be considered when preventing or treating it. “We push diabetes management as a whole body approach. So not only are endocrinologists involved, but also diabetes educators, dietitians and psychologists,” Viswanathan says.

Both types of diabetes can decrease life span by 10 years. About 8.1 million people may be undiagnosed with diabetes and unaware of their condition, according to the National Diabetes Statistics Report for 2014. Many with diabetes may go on without symptoms for up to seven years.

Early screening is advisable for those experiencing symptoms of diabetes, such as excessive thirst, eating and urination, as well as fatigue. Screening is also advised for those with risk factors, such as being obese, having a body mass index (BMI) above 25 or having a close family member with diabetes. Having blood pressure above 135/80 without symptoms of other medical conditions warrants screening, according to the U.S. Preventive Services Task Force.

Diabetes does not discriminate; we are all at risk. There’s little we can do to prevent Type 1 diabetes, but we can make a difference in the skyrocketing rate of Type 2 diabetes. Changes must occur in education and awareness of nutrition and exercise, as well as the consequences of obesity and bad health habits. Only then will we be able to put diabesity to rest.

Originally published in the Winter/Spring 2015 print edition

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