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Functional Medicine Explained
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Diabesity is a term that ties diabetes type II and obesity. Is this the first time you’ve heard about this? I don’t think so. Unfortunately, diabetes prevalence has been on the rise, and it is estimated to be 171 million globally and projected to double this number in the year 2030. Diabesity, as we said before, is the ensemble of an excess of body weight, which will increase the amount of abdominal fat and, lastly, affect insulin resistance.

 

Diabetes

When we talk about a set of diseases that affect one patient, we must think about the risk that each one of them confers. A progressive multifactorial metabolic disease, characterized by hyperglycemia or high blood glucose and caused by insulin derangements, is what we know as Diabetes. Conversely, diabetes can cause serious complications that can lead to limb amputations caused by macrovascular and microvascular complications, cardiovascular disease or stroke, and renal disease.

 

Obesity

On the other hand, obesity has its own set of issues. Still, it has one extra component that we need to talk about: weight gain associated with excess fat that will commonly accumulate in the abdominal area. Excess weight is progressive, and it can be categorized in multiple ranges, the WHO classifies this issue using the Body Mass Index or BMI.

Nutritional Status Underweight Normal weight Pre-obesity (overweight) Obesity class I Obesity class II Obesity class III
BMI  kg/m2 below 18.5 18.5-24.9 25.0-29.9 30.0-34.9 35.0-39.9 Above 40

An excess of body weight has been linked to an imbalance between energy intake and energy expenditure. Hence, an unbalanced high-calorie diet with high sugar foods and no exercise are major key factors that will facilitate extra weight that will escalate until we hit an overweight BMI and then obesity.

Nevertheless, obesity has its own complications: it increases diabetes, coronary heart disease, hypertension, hyperlipidemia, and certain cancers. Diabesity has been liked to chronic stress, increased states of inflammation, oxidative stress, and depression.

Monitoring and prevention

Diagnosis and treatment of diabesity involve the monitoring of blood glucose, measuring the amount of insulin produced by our b-cells in our pancreas, and medication such as insulin, insulin sensitizers (TZDs: rosiglitazone, pioglitazone), insulin secretagogues (sulphonylureas), and modulators of hepatic glucose production (metformin).

 

 

Furthermore, diet therapy and exercise are fundamental to the management of this disease. I don’t know if you notice, but the root cause of obesity (weight gain) is the lack of these two components. Hence, the need to start changing a sedentary lifestyle to an active one and increase those veggies in your diet!

Did you know? The US Diabetes Prevention Program showed that reducing 7% body weight through lifestyle changes like moderate physical activity and a calorie-reduced diet decreased the risk of progression and risk of developing diabetes type II.

How can I start reducing my risk or progression of diabesity? From Functional Medicine in Cleveland clinic, Dr. Mark Hyman establishes that optimal management of certain markers will promote better health.

Fasting blood glucose: This is a snapshot of your blood sugar in time. It may not be the best way to monitor our glucose since it’s better to correlate this measurement with HbA1C.

  • Normal 65-99 mg/dL
  • Optimal 70-80 mg/dL

Fasting insulin: Insulin is the hormone that leads our blood glucose to the cells to be metabolized and used for energy in our body. If insulin levels are high for a short period of time, there might be a chance that your blood glucose is not affected. Unfortunately, your blood glucose will be out of range when insulin levels have been on the rise for a prolonged time.

  • Normal: 2.6−24.9 μIU/mL
  • Optimal: <5 μIU/mL
  • Optimal 1 hour and 2 hours post sugar challenge: <30 μIU/mL

HbA1C: HbA1C is a measure that monitors the amount of glucose over a long period of time, 6 weeks.   

  • Normal 4.8% – 5.6%
  • Optimal 4.8% – 5.5 %

Lastly, the best way to treat this epidemic disorder is to prevent it. Several authors recommend early screening at 30 years old when the patient is considered at risk: living a sedentary lifestyle and increased waist-to-hip ratio. A healthy lifestyle and monitoring should be installed as the primary line of treatment.

Farag, Youssef MK, and Mahmoud R. Gaballa. “Diabesity: an overview of a rising epidemic.” Nephrology Dialysis Transplantation 26.1 (2011): 28-35.

Colagiuri, Stephen. “Diabesity: therapeutic options.” Diabetes, Obesity, and Metabolism 12.6 (2010): 463-473.

Hyman, Mark. “Diabesity and prevention” Commune, 2020, https://www.onecommune.com/products/hacking-your-healthcare-with-dr-mark-hyman/categories/1666653/posts/5602690.

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