Diabetes affects more than 100 million people in the U.S. — about a third of the total population. Millions more have pre-diabetes, a collection of medical problems that makes them more prone to developing diabetes within five years or less. The number of people with type 2 diabetes has skyrocketed over the past decade or so as obesity has reached epidemic proportions. In fact, according to the CDC, in the U.S., about 40 percent of adults and about 20 percent of children and adolescents are obese. Although researchers knew diabetes and obesity were linked in some way, only recently have they begun to understand the relationships between these two serious medical problems.
Although both type 1 and type 2 share many of the same symptoms, their underlying causes are very different.
Type 1 diabetes is sometimes referred to as juvenile diabetes because it usually develops during childhood or the teenage years. Type 1 diabetes is considered an autoimmune disease. That means your body’s immune system attacks healthy cells — in this case, the cells in your pancreas that help your body process insulin. Insulin is necessary for metabolizing sugars called glucose, which are essential for providing your body’s cells and organs with energy. As more and more of these insulin-producing cells are destroyed, your body produces less and less insulin, and that means excess sugar or glucose builds up in your blood instead of being metabolized by your muscles. People with type 1 diabetes will need to use insulin throughout their lives to make up for the insulin their bodies can no longer produce.
Type 2 diabetes is considered a metabolic disease. It tends to occur during adulthood, but in recent years, the number of children with type 2 diabetes has skyrocketed, right along with childhood obesity. In type 2 diabetes, your body produces insulin, but it’s either unable to process it or it doesn’t produce the amount of insulin you need to metabolize blood sugar efficiently. Type 2 diabetes is much more common among people who are obese, although you don’t always need to be overweight to have type 2 diabetes.
For years, researchers knew that people who were obese were at a greater risk of developing diabetes compared to people who were not obese. In fact, some studies suggest obesity increases the risk of type 2 diabetes by as much as three to seven times, and up to 20 times in people who are very obese (BMI greater than 35). That risk increases for people of all ages — kids as well as adults. The link between diabetes and obesity is so strong that researchers have coined the term “diabesity” to describe the relationship between the two.
The link between obesity and diabetes is complex, but researchers agree two main factors are at play: an increase in insulin resistance and a decrease in insulin secretion. Both of these problems occur early on in obesity, and they become worse the longer a person remains obese. In insulin resistance, your body becomes increasingly unable to process and use insulin. When combined with a decline in insulin secretion and production, the risk for diabetes increases dramatically.
But why do these two effects occur? That’s when things get a lot more complicated. Some studies suggest the excess fatty tissue begins acting like an extra “organ,” secreting hormones that affect insulin production and insulin use. Excess fatty tissue may also secrete materials that are toxic to the cells used to process insulin. Inflammation — especially the chronic inflammation common in obesity — may interfere with insulin production and insulin sensitivity. And more recently, scientists discovered obesity makes it much harder for insulin to pass into the muscles, which makes it much more difficult for insulin to be processed and used by the body. At some point, drugs may be developed to target these or other mechanisms that are yet to be defined. But for now, daily management of glucose and insulin remains the cornerstone for diabetes treatment for both adults and children.
Diabetes increases your risks of developing several other diseases and medical problems, and controlling your blood sugar is the key to reducing those risks. As a top-ranked specialist in St. Clair Shores, Dr. Vincent Maribao helps patients learn how to manage their diabetes with lifestyle changes, eating plans and medication when necessary. If you’ve been diagnosed with diabetes or if you’d like to find out if you’re at risk for diabetes, contact the practice today.