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How Does Obesity Cause Type 2 Diabetes Mellitus?

What Causes Type 2 Diabetes?

What Causes Type 2 Diabetes?

Insulin resistance and high levels of insulin and lipids all precede the development of metabolic dysfunction. Which metabolic factor is to blame? Type 2 diabetes is a multifactorial metabolic disease.1 Obesity, elevated levels of lipids and insulin in the blood, and insulin resistance all accompany the elevated blood glucose that defines diabetes. (Diabetes is defined as fasting blood glucose concentrations above 7 millimolar (mM), or above 11 mM two hours after ingestion of 75 grams of glucose.) But while researchers have made much progress in understanding these components of the metabolic dysfunction, one major question remains: What serves as the primary driver of disease? Lifestyle choices characterized by inactivity have been postulated as one possible cause. Researchers have also pointed the finger at nutrition, postulating that poor food choices can contribute to metabolic disease. However, there is thus far weak support for these hypotheses. Changing to a healthy diet typically does not result in significant weight loss or the resolution of metabolic dysfunction, and it is rare to reverse obesity or diabetes through increased exercise. Furthermore, there does not appear to be a strong relationship between body-mass index (BMI) and activity level, though exercise clearly has many other health benefits. With such macroscale factors unable to explain most cases of obesity and diabetes, scientists have looked to molecular mechanisms for answers. There are at least 40 genetic mutations known to be associated with type 2 diabetes. These genes tend to be involved in the function of pancreatic β cells, which secrete insulin in response to elevated levels of the three types of cellular fuel: sugar, fat, and protein. In healthy young adults, circulating glucose concent Continue reading >>

Obesity And Diabetes

Obesity And Diabetes

Doctors and researchers have found that obesity and diabetes are connected. Persons who are obese are at high risk for developing Type 2 diabetes (also known as "insulin-resistant" or "adult-onset" diabetes), particularly if a close family member is affected with diabetes. Therefore, it becomes very important to maintain a healthy body weight throughout your life in order to protect yourself from developing a chronic disease like diabetes. As nurses associated with the Genetics of the Acadian People projects, we have been asked questions at public forums concerning obesity and diabetes. The following is a list of some of the most commonly asked questions, together with our answers and advice. Is obesity caused by a specific genetic defect? Researchers have not yet discovered a specific gene that causes obesity, although several genes are considered to be important in playing a part. However, we have come to understand that a person's genetic make-up can result in a predisposition to becoming obese. This means that a person may be particularly susceptible to becoming obese through experiencing risk factors in their life, like high calorie or high fat diets and lack of exercise. Your genetic make-up, which you have inherited from your parents, may contribute to your general body type, including how and where your body deposits fat in certain places such as buttocks or thighs. There seems to be a strong connection between abdominal fat and diabetes. What, then, is the major cause of obesity? The environment plays a much larger role in a person's likelihood of becoming obese than does any specific gene. By "environment," we mean not only what the outside world does to a person's body but also what enters a person's body through eating and drinking. The two main factors that Continue reading >>

Type 2 Diabetes Mellitus In Childhood: Obesity And Insulin Resistance

Type 2 Diabetes Mellitus In Childhood: Obesity And Insulin Resistance

As rates of childhood obesity climb, type 2 diabetes mellitus has increasingly been diagnosed in children and adolescents, with the highest incidence occurring among youth from racial and ethnic minority backgrounds. The serious complications associated with type 2 diabetes mellitus make it essential for physicians to be aware of risk factors and screening guidelines, allowing for earlier patient diagnosis and treatment. It is also important for physicians to be aware of the treatment options available, including weight control through diet and exercise as well as common pharmacotherapeutic options. According to the SEARCH for Diabetes in Youth Study Group,8 incidence rates among American Indians aged 15 to 19 years is 49.4%, compared to 5.6% in non-Hispanic whites of the same age group. Among youth in the United States, Pima Indian adolescents have the highest reported prevalence of type 2 diabetes mellitus. For Pima Indian children aged 5 to 9 years, the incidence rate is less than 0.5%; for children and adolescents aged 10 to 14 years, 1.5% to 3%; and for adolescents and young adults aged 15 to 19 years, 4% to 5%.7 Neel9 postulated that, when humans were hunter-gatherers and did not know when the next meal was expected, some individuals developed “thrifty genes.” These genes caused the body to become insulin resistant by interfering with mechanisms that allowed blood glucose to be transported into cells where it would be phosphorylated and used for energy. Consequently, the pancreas had to make more insulin. The excess insulin allowed cells to store fat for use during times of relative famine, leading to a much higher survival rate.9-11 These genes may include uncoupling proteins, PPAR-γ and PPAR-α, CALPAIN 10, and adrenergic receptor polymorphisms.12-14 Athero Continue reading >>

Obesity And Type 2 Diabetes Mellitus

Obesity And Type 2 Diabetes Mellitus

It is now widely accepted that the obesity epidemic continues to be the principal driver for the rising global prevalence of type 2 diabetes mellitus (1). With the unabated increase in the prevalence of obesity, every year the World Health Organization (WHO) has to increase the projected global figures of the number of people with diabetes for 2030. The latest figure of 532 million people who will develop diabetes by 2030 will likely be revised (2). Canada's obesity prevalence rate of 25.5% ranks fourth among the OECD countries, behind the United States (34.3%), Mexico (30%) and New Zealand (26.5%), and ahead of the United Kingdom (24%) (1). Sadly, the latest figures on adult Canadians who are overweight and obese based on self-reported body mass indices show no reversal in its prevalence and trends. According to data released by Statistics Canada earlier this year (based on self-reported body mass indices), 52% of Canadians age 18 years and over are overweight or obese (3). The number of overweight/obese Canadians continue to rise over the past 5 years, from 12.1 million in 2007 to 13.2 million in 2011 (8.8% increase) (3). More than 60% of men age 35 years and older are overweight or obese and there has been a 20% increase since 2007 (3). Over the last 2 decades, the average self-reported body mass index (BMI) of adult Canadians has increased by approximately 3 kg/m2, from 22.3 to 25.3 kg/m2, which is in the overweight range (4). Obesity rates have roughly doubled across all age groups over the past 3 decades, and we are less physically fit (5)! Importantly, 20% of Canadian youths are overweight or obese, and the number continues to rise, notably in the Maritime provinces (3). This issue of the Canadian Journal of Diabetes, published on the occasion of the 3rd Canadian Continue reading >>

Type 2 Diabetes Causes

Type 2 Diabetes Causes

Type 2 diabetes has several causes: genetics and lifestyle are the most important ones. A combination of these factors can cause insulin resistance, when your body doesn’t use insulin as well as it should. Insulin resistance is the most common cause of type 2 diabetes. Genetics Play a Role in Type 2 Diabetes Type 2 diabetes can be hereditary. That doesn’t mean that if your mother or father has (or had) type 2 diabetes, you’re guaranteed to develop it; instead, it means that you have a greater chance of developing type 2. Researchers know that you can inherit a risk for type 2 diabetes, but it’s difficult to pinpoint which genes carry the risk. The medical community is hard at work trying to figure out the certain genetic mutations that lead to a risk of type 2. Lifestyle Is Very Important, Too Genes do play a role in type 2 diabetes, but lifestyle choices are also important. You can, for example, have a genetic mutation that may make you susceptible to type 2, but if you take good care of your body, you may not develop diabetes. Say that two people have the same genetic mutation. One of them eats well, watches their cholesterol, and stays physically fit, and the other is overweight (BMI greater than 25) and inactive. The person who is overweight and inactive is much more likely to develop type 2 diabetes because certain lifestyle choices greatly influence how well your body uses insulin. Lack of exercise: Physical activity has many benefits—one of them being that it can help you avoid type 2 diabetes, if you’re susceptible. Unhealthy meal planning choices: A meal plan filled with high-fat foods and lacking in fiber (which you can get from grains, vegetables, and fruits) increases the likelihood of type 2. Overweight/Obesity: Lack of exercise and unhealthy me Continue reading >>

Causes

Causes

Type 2 diabetes occurs when the pancreas doesn't produce enough insulin to maintain a normal blood glucose level, or the body is unable to use the insulin that is produced (insulin resistance). The pancreas is a large gland behind the stomach that produces the hormone insulin. Insulin moves glucose from your blood into your cells, where it's converted into energy. In type 2 diabetes, there are several reasons why the pancreas doesn't produce enough insulin. Risk factors for type 2 diabetes Three of the main risk factors for developing type 2 diabetes are: age – being over the age of 40 (over 25 for people of south Asian, Chinese, African-Caribbean or black African origin, even if you were born in the UK) genetics – having a close relative with the condition, such as a parent, brother or sister weight – being overweight or obese People of south Asian and African-Caribbean origin also have an increased risk of developing complications of diabetes, such as heart disease, at a younger age than the rest of the population. Read about reducing your risk of type 2 diabetes. Age Your risk of developing type 2 diabetes increases with age. This may be because people tend to gain weight and exercise less as they get older. Maintaining a healthy weight by eating a healthy, balanced diet and exercising regularly are ways of preventing and managing diabetes. White people over the age of 40 have an increased risk of developing the condition. People of south Asian, Chinese, African-Caribbean and black African origin have an increased risk of developing type 2 diabetes at a much earlier age. However, despite increasing age being a risk factor for type 2 diabetes, over recent years younger people from all ethnic groups have been developing the condition. It's also becoming more comm Continue reading >>

Does Obesity Cause Type 2 Diabetes?

Does Obesity Cause Type 2 Diabetes?

There is a close link between obesity and diabetes type 2 risk. In fact, the majority of American overweight/obese adults either have type 2 diabetes or prediabetes. Therefore, weight loss is a good place to start in beating this silent killer. When a person puts on 11 to 16 pounds of body weight they have double the risk of developing type 2 diabetes. Those who gain 17 to 24 pounds triple their risk. Losing about 10 percent of your body weight (if you’re overweight or obese) can help with insulin sensitivity and blood sugar management. It’s time to break free from old programming that says we should eat what we want, when we want in the quantities we want and instead start to nourish our bodies and move our bodies to reclaim our natural state of wellness. And since diabetes follows a progressive course, we must intervene early before it’s too late. Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Print Overview Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel. With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level. More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy. Symptoms Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for: Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual. Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger. Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses alternative fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine. Fatigue. If your cells are deprived of sugar, you may become tired and irritable. Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus. Slow-healing sores o Continue reading >>

Why Does Obesity Cause Diabetes?

Why Does Obesity Cause Diabetes?

Being overweight or obese increases the chances of developing the common type of diabetes, type 2 diabetes. In this disease, the body makes enough insulin but the cells in the body have become resistant to the salutary action of insulin. Why does this happen? New Research: A report this week in Science proposes that being overweight stresses the insides of individual cells. Specifically, overeating stresses the membranous network inside of cells called endoplasmic reticulum (ER). When the ER has more nutrients to process than it can handle, it sends out an alarm signal telling the cell to dampen down the insulin receptors on the cell surface. This translates to insulin resistance and to persistently high concentrations of the sugar glucose in the blood -- one of the sure signs of diabetes. Comment: Research into diabetes today is far ranging. It ranges from the environment to the deep dark recesses of the single cell. It is much easier to look at the environment, for example, "Super Size Me" in a fast-food culture, than it is to sort out what is going on inside the workings of an individual cell. Barbara K. Hecht, Ph.D. Frederick Hecht, M.D. Medical Editors, MedicineNet.com Study Suggests How Obesity Causes Diabetes HealthDay Reporter THURSDAY, Oct. 14 (HealthDayNews) -- Scientists know that obesity is a key player in the development of type 2 diabetes, but exactly how excess weight causes the disease isn't clear. While trying to answer that question, Harvard University researchers have discovered a new pathway that sets in motion a series of reactions that leads to the development of insulin resistance, a precursor of type 2 diabetes, a new study reports. The researchers found that obesity causes stress in a system of cellular membranes called endoplasmic reticulum (ER Continue reading >>

Lifestyle Causes Of Diabetes Mellitus Type 2

Lifestyle Causes Of Diabetes Mellitus Type 2

A number of lifestyle factors are known to be important to the development of diabetes mellitus type 2 including: obesity, physical activity, diet, stress, and urbanization.[1] Excess body fat underlies 64% of cases of diabetes in men and 77% of cases in women.[2] A number of dietary factors such as sugar sweetened drinks[3][4] and the type of fat in the diet appear to play a role.[5] In one study, those who had high levels of physical activity, a healthy diet, did not smoke, and consumed alcohol in moderation had an 82% lower rate of diabetes. When a normal weight was included, the rate was 89% lower. In this study, a healthy diet was defined as one high in fiber, with a high polyunsaturated to saturated fat ratio, lower trans fats consumption, and a lower mean glycemic index.[6] Dietary[edit] The composition of dietary fat intake is linked to diabetes risk; decreasing consumption of saturated fats and trans fatty acids while replacing them with unsaturated fats may decrease the risk.[5][7] Sugar sweetened drinks appear to increase the risk of type 2 diabetes both through their role in obesity and potentially through a direct effect.[3][4] Obesity[edit] Obesity has been found to contribute to approximately 55% of cases of type 2 diabetes;[8] chronic obesity leads to increased insulin resistance that can develop into type 2 diabetes, most likely because adipose tissue (especially that in the abdomen around internal organs) is a source of several chemical signals, hormones and cytokines, to other tissues. Inflammatory cytokines such as TNFα may activate the NF-κB pathway which has been linked to the development of insulin resistance.[9] Gene expression promoted by a diet of fat and glucose, as well as high levels of inflammation related cytokines found in the obese, ca Continue reading >>

Why Does Obesity Cause Diabetes? You Asked Google – Here’s The Answer

Why Does Obesity Cause Diabetes? You Asked Google – Here’s The Answer

‘Cause” is a strong word. It means that A results in B happening. Causality is also surprisingly difficult to prove. Most medical studies only show association between A and B, while causality often remains speculative and frustratingly elusive. Obesity and diabetes are no exception. There are many types of diabetes. All are unified by elevated levels of blood sugar. Type 1 diabetes accounts for less than 10% of cases and results from autoimmune destruction of the beta cells in the pancreas, which produce and release insulin. (In an autoimmune process, antibodies that normally target and fight infection instead target one’s own cells). Type 3c (secondary) diabetes can occur when there has been destruction of the pancreatic beta cells through some other process, such as excessive alcohol, inflammation or surgical resection. There are also many genetic forms of diabetes, each usually resulting from a single gene mutation that affects pancreatic function in some way. Finally, there is type 2 diabetes (T2D), which accounts for more than 90% of cases globally. Media reports of diabetes, particularly in the context of obesity, usually relate to T2D, the two terms often being used interchangeably. Only T2D appears to be associated with obesity. Epidemiological studies across the world have shown that the greater one’s body mass index (BMI), the greater the chance of developing T2D. However, this is not the same as saying that obesity causes T2D. The majority of people who are obese will never develop T2D – a fact that exposes the statement “obesity causes diabetes” as absurd. Rather than referring to obesity as a cause of diabetes, it is more accurate to frame the issue as one of association between obesity and T2D (which is incontrovertibly true). As we gain wei Continue reading >>

Metabolic Mechanisms In Obesity And Type 2 Diabetes: Insights From Bariatric/metabolic Surgery

Metabolic Mechanisms In Obesity And Type 2 Diabetes: Insights From Bariatric/metabolic Surgery

Abstract Obesity and the related diabetes epidemics represent a real concern worldwide. Bariatric/metabolic surgery emerged in last years as a valuable therapeutic option for obesity and related diseases, including type 2 diabetes mellitus (T2DM). The complicated network of mechanisms involved in obesity and T2DM have not completely defined yet. There is still a debate on which would be the first metabolic defect leading to metabolic deterioration: insulin resistance or hyperinsulinemia? Insight into the metabolic effects of bariatric/metabolic surgery has revealed that, beyond weight loss and food restriction, other mechanisms can be activated by the rearrangements of the gastrointestinal tract, such as the incretinic/anti-incretinic system, changes in bile acid composition and flow, and modifications of gut microbiota; all of them possibly involved in the remission of T2DM. The complete elucidation of these mechanisms will lead to a better understanding of the pathogenesis of this disease. Our aim was to review some of the metabolic mechanisms involved in the development of T2DM in obese patients as well as in the remission of this condition in patients submitted to bariatric/metabolic surgery. © 2015 S. Karger GmbH, Freiburg Introduction Obesity has become a real concern worldwide due to its increasing prevalence and to the associated cluster of diseases that reduce life quality and expectancy. Patients with BMI over 40 kg/m² as well as those with a BMI over 35 kg/m² and comorbidities, who have failed to obtain and maintain significant weight reduction through nonsurgical means, are submitted to bariatric surgery in order to reach the weight goals [1]. Type 2 diabetes mellitus (T2DM) is the major comorbidity of obesity, and therefore the terms ‘diabesity' and Continue reading >>

Insulin Resistance Is Not Necessarily An Essential Component Of Type 2 Diabetes1

Insulin Resistance Is Not Necessarily An Essential Component Of Type 2 Diabetes1

Insulin resistance and impaired insulin secretion are usually present in patients with classic type 2 diabetes as well as in most people with impaired glucose tolerance ( 1 , 2 ). Both play important roles not only in determining whether diabetes occurs, but also in determining the magnitude of the accompanying hyperglycemia and other metabolic abnormalities ( 3 , 4 ). The vast majority of patients with type 2 diabetes are obese. As obesity causes insulin resistance ( 5 , 6 ), it is easy to understand why insulin resistance would be so commonly involved. There is mounting evidence ( 7 13 ) suggesting that the fundamental pathological sequence of events that leads to classic type 2 diabetes in most instances is the superimposition of obesity-related insulin resistance upon a -cell with a genetically limited capacity to compensate. This view has recently received support from several studies ( 8 , 13 15 ). In two of these ( 8 , 13 ), it was found that when matched for obesity, normal glucose-tolerant, first degree relatives of patients with type 2 diabetes had impaired insulin secretion, but were not insulin resistant. Similarly, in another study ( 14 ) it was shown that normal glucose-tolerant monozygotic twins of someone with type 2 diabetes had impaired -cell function, but normal insulin sensitivity; moreover, monozygotic twins who had developed impaired glucose tolerance had the same degree of impaired insulin secretion as those who had maintained normal glucose tolerance, but they had a greater body mass index and waist to hip ratio and were insulin resistant. Thus, one could infer that the addition of obesity-related insulin resistance caused deterioration of their glucose tolerance, and without this they might have maintained normal glucose tolerance. Accordingly, Continue reading >>

> Weight And Diabetes

> Weight And Diabetes

A balanced diet and an active lifestyle can help all kids maintain a healthy weight. For kids with diabetes, diet and exercise are even more important because weight can affect diabetes and diabetes can affect weight. This is true for kids and teens with type 1 diabetes or type 2 diabetes. In diabetes, the body doesn't use glucose properly. Glucose, a sugar, is the main source of energy for the body. Glucose levels are controlled by a hormone called insulin, which is made in the pancreas. In type 1 diabetes, the pancreas does not make enough insulin. Undiagnosed or untreated type 1 diabetes can cause weight loss. Glucose builds up in the bloodstream if insulin isn't available to move it to the muscles. When glucose levels become high, the kidneys work to get rid of it through urine. This causes weight loss due to dehydration and loss of calories from the sugar that wasn't used as energy. Kids who develop type 1 diabetes often lose weight even though they have a normal or increased appetite. Once kids are diagnosed and treated for type 1 diabetes, weight usually returns to normal. Developing type 1 diabetes isn't related to being overweight, but keeping a healthy weight is important. Too much fat tissue can make it hard for insulin to work properly, leading to both higher insulin needs and trouble controlling blood sugar. In type 2 diabetes, the pancreas still makes insulin, but the insulin doesn't work in the body like it should and blood sugar levels get too high. Most kids and teens are overweight when they're diagnosed with type 2 diabetes. Being overweight or obese increases the risk for developing type 2 diabetes. Also, weight gain in people with type 2 diabetes makes blood sugar levels even harder to control. People with type 2 diabetes have a condition called ins Continue reading >>

© Van Zuiden Communications B.v. All Rights Reserved.

© Van Zuiden Communications B.v. All Rights Reserved.

174 m a y 2 0 1 3 , v o l . 7 1 , n o 4 r e V i eW obesity-associated low-grade inflammation in type 2 diabetes mellitus: causes and consequences M.M.J. van Greevenbroek*, C.G. Schalkwijk, C.D.A. Stehouwer Department of Internal Medicine & Laboratory for Metabolism and Vascular Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands, *corresponding author: tel. + 31 (0)43-3882135, fax +31 (0)43-3670916, e-mail: [email protected] a b s t r aC t The epidemic of overweight and obesity is a major problem because of the plethora of health and economic issues that it induces. Key among these is the sharply increasing prevalence of type 2 diabetes (T2D) and cardiovascular disease. The development of T2D is characterised by two processes: 1) insulin resistance, resulting from impaired insulin signalling and leading to an increased demand for insulin, which must be met by increased insulin production by pancreatic b-cells (compensatory b-cell function); and 2) b-cell dysfunction, with T2D developing when the amount of insulin that is produced is insufficient to meet the demand. Overweight and obesity, especially in case of abdominal fat accumulation, are associated with systemic low-grade inf lammation. This low-grade inf lammation is characterised by, among other things, higher levels of circulating proinflammatory cytokines and fatty acids. These can interfere with normal insulin function and thereby induce insulin resistance, and have also been implicated in b-cell dysfunction. This review focuses on the known and emerging relations between inflammation and T2D. We first discuss current views on the effects of fat distribution on adipose tissue inflammation and adipose tissue dysfunction. Next we focus on the detrimental roles of pr Continue reading >>

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