Medicine:Diabesity
Diabesity is a global epidemic characterized by the co-occurrence of obesity and type 2 diabetes; excess body fat is the most significant risk factor for type 2 diabetes.[1]
Description
The global disease burden of obesity and type 2 diabetes has greatly increased since the twentieth century and is projected to continue to increase in the twenty-first century.[1] Although it is not fully understood how insulin resistance develops, lifestyle factors are crucial to the development of both illnesses[2] and excess body fat is the most significant risk factor for type 2 diabetes.[1] Common comorbidities include non-alcoholic fatty liver disease, dyslipidemia, high blood pressure, cardiovascular disease, obstructive sleep apnea, and chronic kidney disease.[2]
Gestational diabetes in women whose pre-pregnancy weight was normal is metabolically distinct from the case where obesity existed prior to pregnancy (termed "gestational diabesity" in one review article).[3]
While altered gut microbiota can lead to the development of diabesity, the reverse is also the case. Therapies aimed at altering gut microbiota are a target of drug discovery[4] and lifestyle interventions.[2]
Management
It is recommended to manage diabesity by a low calorie diet, increased exercise, and where indicated, bariatric surgery. Weight loss of 15 kilograms (33 lb) can reverse type 2 diabetes in around 70 percent of patients. This is difficult for most patients to achieve in practice, but even smaller losses of 5 kilograms (11 lb) can improve diabetes. While some antidiabetic drugs such as insulin can cause weight gain and worsen diabesity, others such as metformin, SGLT-2 inhibitors, and GLP-1 receptor agonists reduce body weight and hyperglycemia. Therefore, the latter are recommended for patients with diabesity.[2]
Cannabinoid receptor antagonists have been developed for diabesity but none are currently approved because of safety concerns.[5]
References
- ↑ 1.0 1.1 1.2 Ng, Arnold C. T.; Delgado, Victoria; Borlaug, Barry A.; Bax, Jeroen J. (April 2021). "Diabesity: the combined burden of obesity and diabetes on heart disease and the role of imaging" (in en). Nature Reviews Cardiology 18 (4): 291–304. doi:10.1038/s41569-020-00465-5. ISSN 1759-5010. https://www.nature.com/articles/s41569-020-00465-5.
- ↑ 2.0 2.1 2.2 2.3 Michaelidou, Maria; Pappachan, Joseph M; Jeeyavudeen, Mohammad Sadiq (15 April 2023). "Management of diabesity: Current concepts". World Journal of Diabetes 14 (4): 396–411. doi:10.4239/wjd.v14.i4.396. ISSN 1948-9358. PMC 10130896. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130896/.
- ↑ Cornejo, Marcelo; Fuentes, Gonzalo; Valero, Paola; Vega, Sofía; Grismaldo, Adriana; Toledo, Fernando; Pardo, Fabián; Moore‐Carrasco, Rodrigo et al. (2021). "Gestational diabesity and foetoplacental vascular dysfunction". Acta Physiologica 232 (4). doi:10.1111/apha.13671.
- ↑ Sharma, Arun K.; Sharma, Akash; Lal, Samridhi; Kumar, Ashish; Yadav, Nirmala K.; Tabassum, Fauzia; Sayeed Akhtar, Md.; Tarique Imam, Mohammad et al. (1 May 2023). "Dysbiosis versus diabesity: Pathological signaling and promising therapeutic strategies". Drug Discovery Today 28 (5): 103558. doi:10.1016/j.drudis.2023.103558. ISSN 1359-6446. https://www.sciencedirect.com/science/article/abs/pii/S1359644623000740.
- ↑ Deeba, Farah; Kumar, Ashish; Mukherjee, Monalisa; Sharma, Arun K.; Sharma, Manju (1 July 2021). "Targeting the endocannabinoid system in diabesity: Fact or fiction?". Drug Discovery Today 26 (7): 1750–1758. doi:10.1016/j.drudis.2021.03.022. ISSN 1359-6446. https://www.sciencedirect.com/science/article/abs/pii/S1359644621001586.
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