June 20, 2023
The Dual Pandemic: Unraveling the Complex Relationship Between Type 2 Diabetes and Obesity
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Obesity is a chronic disease that can lead to a multitude of metabolic complications, such as hypertension and high cholesterol, as well as mechanical complications, such as obstructive sleep apnea, urinary incontinence, and osteoarthritis. However, a more common occurrence is that a gain in weight can also lead to insulin resistance (the hallmark of type 2 diabetes), and therefore, these two conditions usually tend to occur simultaneously.
When looking into the correlation between the two conditions, a complex pathway is seen involving various physiological and lifestyle factors. Understanding this relationship is crucial to developing effective prevention and management strategies for both diseases.
One of the hallmarks of the interlink between the two conditions is that the presence of obesity can worsen the complications arising from type 2 diabetes. These may include nephropathy, retinopathy, neuropathy, etc. These complications can also be more challenging to manage in individuals with obesity, potentially leading to poorer health outcomes.
Managing both obesity and type 2 diabetes requires a comprehensive approach that begins with lifestyle changes. At its base, this would include adopting a healthy diet, engaging in regular physical activity, achieving and maintaining a healthy weight, and monitoring blood sugar levels. Healthcare professionals play a crucial role in providing this initial guidance and support for individuals with these conditions. Further treatments should then be multifaceted and include medications, surgery, and monitoring and treatment of complications.
Of note, it is imperative that clinicians should treat patients with type 2 diabetes and obesity aggressively to prevent long-term sequelae of both chronic diseases. However, these treatments do not have to be mutually exclusive as the initial treatment modalities for both obesity and type 2 diabetes (as per their respective algorithms) include weight loss interventions such as diet and exercise. Moving further with the treatment processes and with the popularity of obesity currently in the mainstream; it would be apropos for clinicians to look at comorbidities more closely when choosing agents for treating obesity. Examples of this include the selection of GLP-1 agonist medications in obese patients with type 2 diabetes. As per current literature, this class of medications tends to show blood glucose control, weight loss, and cardiac benefits for patients with coronary artery disease.
In conclusion; by working to develop an approach to obesity treatment that is tailored to each patient, clinicians can play a significant role in helping reduce the risk of developing type 2 diabetes and improving the overall health and well-being of their patients.
For additional information, the OMA website is a significant resource for addressing type 2 diabetes and obesity. The Obesity Algorithm is also useful for learning about the comorbidities associated with obesity, especially type 2 diabetes.
Article written by:
Peminda K. Cabandugama MD, DABOM
Peminda K Cabandugama, MD, DABOM, is the Director of Digital Obesity at the Cleveland Clinic in Ohio. He is also a Founding Member of the Midwest Obesity Society and its former Vice President. Dr. Cabandugama is currently also a member of the Obesity Medicine Association (OMA) Outreach Committee as well as a member of The Obesity Society (TOS) Spokesperson Network. He is board-certified in Internal Medicine, Endocrinology, Diabetes and Metabolism, and Obesity Medicine