Secondly, there is also a biological link, which is the fundamental reason, between the type 2 diabetes and obesity. In 2001, Lazar reported on Nature that resistin is a potentialhormone linking obesity to type 2 diabetes,[10]which was a major breakthrough in the relationship between type 2 diabetes and obesity. After 15 years’ development, the pathophysiology of obesity-inducedtype 2 diabetes has shown the complicated mechanismsin a clearer manner. Among different hypothesis, there have been two major theories that expounded on the causative relationship between excessive amount of fat and its consequential impact on the function of metabolism related to impaired glucose. The first one is ‘Randle’s cycle’,whichelucidates the reversibly application of the associable correlation between glucoseoxidation and fatty acid oxidation. Another one is the ‘ectopic fat storage hypothesis’, which is based on the impairedinsulin effect as a result of deposition of lipids that takes place in insulin-target tissues. Both researchers coinedthe well-known ‘lipotoxicity theory’ and propose a realisticframework of metabolic mechanism in whichlong termstorage of excessive fat increases with lowering ofinsulin secretory capacity of beta cells and insulin resistance.[4]
Last but not least, alot of factors such as age, ethnicity, physical activity, dietary composition, duration of obesity and even social networkwill affect the relationship between obesity and diabetes in the complex of internal mechanism. The meaning of this is to explain the reasons why 1) one-fifth of patients withtype 2 diabetes do not suffer from obesity and 2) even patientsbelonging to the top risk-group characterized by high BMIscan overcome type 2 diabetes.[4]
IV. Obesity and Type Two Diabetes in Modern Society
In the modern society, obesity and type 2 diabetes have become two serious and aggravatingproblems and thesocial costs incurred are growing increasinglyhuge.
Here are some vivid statuses:in Africa, over three-fourth of deaths caused bydiabetes are among people below 60;Europe suffers the highest popularity of diabetes in terms of the population of children with type 1 diabetes; in the Middle East and North Africa,about one-tenth of the adult populationhas diabetes, but this is surpassed by the figures of South-East Asia, in which about 50% of the population havediabetes undiagnosed; In the Western Pacific, almost 140 millionadults suffer the effect of diabetes, charting at the first place amongtheaforementioned regions.[15]
A paper published in The Lancet showed that, the upsurge of obesity among grown-ups in developed countrieshas decreased since 2006, however, there was still a fast increasing number in developing countries.[12]What’s more important we can conclude from the data is, for developing country obesity will become a burden of disease.
It is not surprising that inhibiting the intensification of type 2 diabetes in the context of developing countrieshas been agrowing challenge, partly because of its close relationship with obesity. According to the data from Wild et al.,[13]diabetes is rapidlymultiplying in magnitude as a worldwide health problem that might be advanced to a pandemic degree by 2030;the population with diabetes globally is predicted togo from 171 million at the start of the 21st centuryto 366 million in a 30-year timeframe (Figure 6).[14]
The increase may bemore prominentin developing countries, for example, India and China will facethe greatest impact. Inthese areas, the caustic reality of type 2 diabetesamong youngstersare also worseningwith anincredible speed, suggesting devastating consequences.[14]
In the developed country due to the better education on prevention of obesity and diabetes, the situation will be better than the developing country but still suffers more. Taking American as the first example, the cases of diabetes in 2030 will become 1.7 times of those in 2000, which actually will increase more greatly than Europe. One of the reasons may be the high-energy dietary habit of Americans. The second example is Australia, where has quite a small number (0.9 million) of diabetes in 2000. This may be due to the small population, life habit and genetic reasons. However, in 2030 the cases increase to 1.7 million which is almost 2 times of that in 2000. Without a doubt, in some developed country, obesity and diabetes are still an important public health issue.
V. Prevention and Treatment of Type Two Diabetes
Knowing the conclusion that obesity has an intense link to the type 2 diabetes, the first task to prevent the type 2 diabetes is removing excess amount of fat.
Mostly,obesity is avoidable with the effort combined by personal habitsand social changes.By getting involved in the diabetes prevention program,[4] changing dietary habits and regular exercises are the principal treatments. Quality of diet can be ameliorated by decrease in consuming high-energy food, such as fatty and sugary materials, which can be replaced by a higher intake of dietary fiber. Medications might be more effective with a controlled diet that is formulated with the suitable principles. In case that the practices mentioned above all fail to provide ideal results, a gastric balloon or surgical process may be conducted to decrease the space inside the stomach or reduce the length of bowel, reducing the appetite of patients or cause a reduced degree innutrient absorption.
Regarding to the treatment of type 2 diabetes itself, besides controlling the weight, there are several points to be mentioned: 1) we can exploit the fundamental principles for the management of diabetesto help control the level of glucose(Table 2);[4] 2) to take physical activity not only‘exercise’, the former one is more general; 3) to take drug under the guidance of doctors since different drugs may be taken due to the considerations of antihypertensive treatment,anti-obesity in diabetic management and hyperglycaemia treatment; 4)to accept metabolic surgery.[4]
Table 2.Fundamental principles for the management of diabetes
VI. Conclusion
In this essay, the author firstly got a well recognition of the definition, history and causes of obesity and diabetes. Then the author moved the attention to the type 2 diabetes because it is the most typical type of diabetes, which can’t be simply treated by taking insulin. With the data and biological references, the author pointed out the fact that a highly positive correlation associating obesity and type 2 diabetes is observable.Comparing the current state of obesity and type two diabetes in two developed countries (American and Australia) and developing countries (China and India) using statistics and graphs,the author figured out a server situation of diabetes for developing countries in the future. Finally, a summary of tackling existing problems in patients and preventive measures of type 2 diabetes was given.
The author believed that the education of obesity and diabetes should be a long-term solution to make people changing their lifestyles to get rid of this two disease. Meanwhile, the global society should pay more attention to defeatingthis two epidemic disease: more education, more financial support and more research with more love and responsibility.
VII. Reference:
[1] Mantzoros, C. S. (2006). Obesity and diabetes. Springer Science & Business Media.
[2] Pollack, Andrew (June 18, 2013). "A.M.A. Recognizes Obesity as a Disease". New York Times. Archived from the original on June 18, 2013.
[3] Haslam DW, James WP (2005). "Obesity". Lancet (Review). 366 (9492): 1197–209.
[4] Barnett, T., & Kumar, S. (Eds.). (2009). Obesity and diabetes (Vol. 34). John Wiley & Sons.
[5]Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., ... & Abraham, J. P. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 384(9945), 766-781.
[6] Bilous, R., & Donnelly, R. (2010). Handbook of diabetes. John Wiley & Sons.
[7] Guariguata, L., Whiting, D. R., Hambleton, I., Beagley, J., Linnenkamp, U., & Shaw, J. E. (2014). Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes research and clinical practice, 103(2), 137-149.
[8] Holt, T., & Kumar, S. (2015). ABC of Diabetes. John Wiley & Sons.
[9] West, K. (1978) Epidemiology of Diabetes and its Vascular Lesions, Elsevier, New York.
[10]Steppan, C. M., Bailey, S. T., Bhat, S., Brown, E. J., Banerjee, R. R., Wright, C. M., ... & Lazar, M. A. (2001). The hormone resistin links obesity to diabetes. Nature, 409(6818), 307-312.
[11]Sattar, N., & Gill, J. M. (2014). Type 2 diabetes as a disease of ectopic fat?. BMC medicine, 12(1), 123.
[12]Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., ... & Abraham, J. P. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 384(9945), 766-781.
[13] Rathmann, W., & Giani, G. (2004). Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes care, 27(10), 2568-2569.
