Millions of people worldwide suffer from diabetes. Insulin resistance is the dominant cause of this. This takes the shape of an epidemic caused by poor eating habits, a sedentary lifestyle and the natural consequence of this - obesity.
Obesity promotes type 2 diabetes
Obesity is accused of favoring the so-called tissue resistance to insulin. There is a special condition in which the pancreas still produces the right amount of insulin, but the body does not seem to "notice" and reacts as if the hormone was missing. For some time it helps to increase the amount of insulin in the patient's blood. However, increased due to excessive fat filling so-called adipocytes require more and more insulin to inject glucose into the body's cells.
Particularly important in the development of tissue resistance to insulin is the so-called visceral fat tissue.
What is insulin resistance of tissues to insulin?
Insulin resistance means the loss of muscle, fat, liver and virtually all body tissues to insulin, which is the "key" permitting glucose inside each cell - where this sugar is burned and provides energy. If fat cells, muscle cells, and livers, which are intensively processing glucose, stop gradually responding to the insulin "key" - they become "closed" for energy supply, i.e. insulin-resistant. Then they become less and less sensitive to glucose from the blood and react less well to it. As a result, normal amounts of insulin cause a much smaller than expected effect of obtaining energy from glucose.
Visceral fat tissue stimulates the development of diabetes
After years of obesity and a condition characterized by an excess of insulin in the blood (hyperinsulinemia) - the secretory reserves of the pancreas are exhausted. The level of glucose in the blood is getting higher and its useless, because it is not burned in cells and in this way converted into energy necessary for life. Advanced diabetes is developing.
Particularly important in the development of tissue resistance to insulin is the so-called visceral fat tissue.
Visual obesity of the "apple" type visually shows it. Among the accompanying visceral obesity, the mediating factors that may cause deterioration in insulin sensitivity are: increased blood levels of free fatty acids (WKT), tumor necrosis factor (TNF-alpha) and leptin.
Based on the waist circumference measurement, visceral obesity levels can be distinguished:
Table 3. Classification of visceral obesity depending on waist circumference
Women
Men
Valid values
<80 cm
<94 cm
I degree of visceral obesity
80-87.9 cm
94 - 101.9 cm
II degree of visceral obesity
> 88 cm
> 102 cm
Are you at risk of type 2 diabetes?
The diagnosis of the type and severity of obesity allows us to assess the risk of type 2 diabetes.
The probability of these disorders is increased if the first degree of visceral obesity occurs with a BMI> 25 kg / m2, and with the second degree of visceral obesity the probability of complications is very high.
Convince yourself of the degree of obesity risk and its possible consequences - diabetes
It has been documented that diabetes does not threaten people with a genetic predisposition, if we maintain our body mass in the normal range. The correct body mass and overweight is determined by the Body Mass Index (BMI) formula. In Polish - this is the body mass index. This indicator - BMI = body weight (kg) /: / divided by the increase in (m2).
The correct BMI, according to the World Health Organization, is for women 22-25, for men 23-27.
BMI over 25 - in a woman and over -27 in a man - means overweight. Above 30 - means obesity. According to many epidemiological studies, BMI correlates well with the mass of adipose tissue and makes it possible to assess the risk of diabetes risk and, moreover, hypertension and heart disease.
The risk of diabetes risk in relation to the BMI index
SURVEY EXCEEDED BY BMI
SURVEY EXCEEDED BY BMI
18,5 - 24,9
standard
> 25
Average
25,0 - 29,9
Elevated - I degree of overweight
30,0 - 39,9
High - II degree of overweight
> 40,0
Very high - 3rd degree of overweight
AN EXAMPLE OF CALCULATION OF BMI INDICATOR
For height = 1.80 m; at weight = 80 kg
Weight 80 kg / (increase 1.80 m) 2> hence BMI = 24.7
which means the weight in the standard and the risk of overpressure within the average values.
But attention - the formula for optimal body mass does not apply to children who grow, athletes and people with extensive muscle tissue, as well as pregnant women.
The most serious clinical consequence of obesity is type 2 diabetes.
About 80% of people with type 2 diabetes are obese. The risk of its occurrence increases with increasing BMI; in people with BMI over 35 it is 80-fold higher than in people with BMI below 23.
The obesity epidemic is triggering an insulin resistance epidemic!
The obesity epidemic currently being observed is a natural consequence of abnormal eating habits ("fast food") and minimal physical activity; it is also partly genetically determined. Obesity leads directly to insulin resistance in people initially predisposed and to the simultaneous manifestation of type 2 diabetes. It is very worrying that this mechanism applies to younger and younger age groups. In some countries, pediatricians report a real epidemic of type 2 diabetes in children and adolescents.
ed. Edward Ozga Michalski, MA
