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Diabetes is a metabolic condition in which the body does not produce sufficient insulin to regulate blood glucose levels or where the insulin produced is unable to work effectively. There are two main types of diabetes: Type 1 diabetes is an auto-immune condition in which the cells that produce insulin are destroyed so lifelong treatment with insulin is required to prevent death. About 10% of people with diagnosed diabetes have type 1 diabetes. Type 2 diabetes accounts for at least 90% of all cases of diabetes.1, 2 it occurs when the body either stops producing enough insulin for its needs or becomes resistant to the effect of insulin produced. The condition is progressive requiring lifestyle management (diet and exercise) at all stages. Over time most people with type 2 diabetes will require oral drugs and or insulin. Type 2 diabetes may remain undetected for many years. Obesity is only associated with type 2 diabetes
There is a close association between obesity and type 2 diabetes. The likelihood and severity of type 2 diabetes are closely linked with body mass index (BMI). There is a seven times greater risk of diabetes in obese people compared to those of healthy weight, with a threefold increase in risk for overweight people. Whilst it is known that body fat distribution is an important determinant of increased risk of diabetes, the precise mechanism of association remains unclear. It is also uncertain why not all people who are obese develop type 2 diabetes and why not all people with type 2 diabetes are obese.
Being overweight or obese is the main modifiable risk factor for type 2 diabetes As BMI increases, so does the risk of type 2 diabetes People with severe obesity are particularly at risk of type 2 diabetes Having a large waist circumference increases the likelihood of developing type 2 diabetes
Being overweight or obese (a BMI of 25kg/m2 or more) is the main modifiable risk factor for type 2 diabetes. The risk of developing type 2 diabetes is associated with incremental increases in body weight in early adulthood. In addition, duration of obesity has also been found to increase risk of developing type 2 diabetes, with greater risk among people who have been obese for longer periods of time. A large waist circumference is associated with increased likelihood of developing type 2 diabetes. Men are at higher risk of type 2 diabetes if they have a waist circumference of 94-102cm and are at very high risk if it is more than 102cm. Women are at higher risk if they have a waist circumference of 80-88cm and at very high risk if it is more than 88cm.
abdominal obesity may cause fat cells to release pro-inflammatory chemicals. These chemicals can make the body less sensitive to the insulin it produces by disrupting the function of insulin responsive cells and their ability to respond to insulin. obesity may trigger changes to the body’s metabolism that cause adipose (fat) tissue to release increased amounts of fatty acids, glycerol, hormones, pro-inflammatory cytokines and other factors that are involved in the development of insulin resistance. When insulin resistance is accompanied by dysfunction of pancreatic islet beta-cells (the cells that release insulin) it leads to failure to control blood glucose levels
Obesity and overweight are major risk factors for type 2 diabetes There is a clear association between increasing age and greater diabetes prevalence Both obesity and type 2 diabetes are strongly associated with unhealthy diets and physical inactivity People from black, Asian and other minority ethnic groups are at an equivalent risk of type 2 diabetes at lower BMI levels than white European populations Deprivation is closely linked to the risk of type 2 diabetes In addition to overweight and obesity, risk factors for developing type 2 diabetes include increasing age, lifestyle factors such as physical inactivity, unhealthy diet, a family history of type 2 diabetes and a history of gestational diabetes or polycystic ovarian syndrome
There is a clear association between increasing age and greater diabetes prevalence. Less than 2% of people aged 16-34 years are estimated to have diabetes compared to 5.1% of people aged 35-54 years, 14.3% of people aged 55-74 years and 16.5% of those aged over 75 years.
Both obesity and type 2 diabetes are strongly associated with an unhealthy diet and physical inactivity. Physical and social environments are important influences on diet and physical activity behavior along with interrelated economic, psychological and cultural factors. Exercise plus dietary changes have been found to be effective in preventing the onset of type 2 diabetes in high risk individuals (those with impaired glucose tolerance or those with metabolic syndrome).
People with diabetes are at risk of a range of health complications including cardiovascular disease, blindness, amputation, kidney disease and depression Diabetes leads to a two-fold excess risk for cardiovascular disease Diabetic retinopathy is the leading cause of preventable sight loss in people of working age Up to 100 people a week have a limb amputated in the UK as a result of diabetes Depression is nearly twice as high among people with type 2 diabetes than in those without the condition. Ninety percent of people with type 2 diabetes are overweight or obese and people with diabetes are at risk of a range of health complications. Uncontrolled diabetes is associated with cardiovascular disease (CVD), blindness, amputation, kidney disease and depression. It can also result in lower life expectancy. Life-long diabetes can also have a profound impact on lifestyle, relationships, work, income, and health and wellbeing.