Friday, May 20, 2022

Obesity and type 2 diabetes: how to avoid the onset of middle-aged diabetes?

A healthy lifestyle and good weight management would be solutions to prevent the onset of type 2 diabetes or middle-age diabetes (fatty diabetes), as confirmed by a Danish study published recently.

Type 2 diabetes or middle age diabetes: from glucagon to blood sugar levels
Obesity is “abnormal or excessive accumulation of body fat that poses a health risk…A person with a body mass index (BMI)* of 30 or more is generally considered obese…” [1]. By 2030, 25% of men and 29% of women will suffer from obesity in Europe [2].

Partly a consequence of obesity and a sedentary lifestyle, type 2 diabetes (T2D) or non-insulin-dependent diabetes affects approximately 5% of the population in France and generally manifests after the age of 40 (it is diagnosed at a average age close to 65 years). T2DM now affects more and more young people, including adolescents and even children [3]. It has also been suggested that the influence of lifestyle and weight loss on T2D risk would vary according to genetic background. It is not secondary diabetes.

Type 2 diabetes (T2DM) results in chronic hyperglycemia linked to improper use of insulin by the body or insufficient insulin secretion to maintain the correct level of glucose in the blood (1g/L). It is also often associated with an elevation of glucagon, a hormone released by the pancreas.

After a meal, the production of glucagon is generally blocked in order to avoid excessive production of glucose by the liver. In a type 2 diabetic patient, this system is faulty and excess glucagon contributes to a sharp rise in blood sugar (fasting blood test for sugar or glucose level assay), as revealed by a recent study [ 4].
The importance of a healthy lifestyle in the prevention of type 2 diabetes or DNID confirmed by a Danish study [5]
The objective of the study (carried out using data from the “Danish Diet, Cancer and Health cohort”) was to find out whether the impact of obesity and a poor lifestyle on the risk of T2D was accentuated by genetic predispositions.

The cohort included 4729 patients who developed T2D during 15 years of follow-up, and 5402 randomly selected Danish subjects. The average age was between 50 and 65 years old and 49.6% were women. The lifestyle score took into account the consumption of cigarettes (tobacco products, e-cigarettes, etc.), alcohol consumption, physical activity and diet.

The authors discovered that obese patients with a BMI of 30 with a poor lifestyle (eating habits, etc.) were associated with a high risk of developing T2DM (10-fold increase) independently of the genetic risk. In addition, they found that the impact of obesity (increased adipose tissue) on the risk of type 2 diabetes was dominant compared to other risk factors and underlined the importance of weight management in the prevention of T2DM. . The obese patient was 8 times more likely to develop T2DM compared to non-obese subjects in the same conditions, even among patients at low genetic risk with a healthy lifestyle.

The authors concluded that managing one’s weight and maintaining a healthy lifestyle (balanced diet, etc.) is crucial in the prevention of T2D regardless of genetic predispositions.

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