Diabetes and obesity together have become a leading health concern all over the world. The two conditions are closely interlinked and most patients with type 2 diabetes are either overweight or are living with obesity. ‘Diabesity’ is the new epidemic that is staring at us.
It is expected that the number of patients with obesity-related diabetes will double and reach up to 300 million by the year 2025. Indians are especially prone to type 2 diabetes due to a genetic predisposition and higher body fat percentage as compared to western population.
Weight management is the need of the hour in patients with type 2 diabetes who are overweight or are living with obesity. Studies have shown that even modest weight reduction can lead to reversal of pre-diabetes and delay the onset of diabetes. This leads to an overall increase in life expectancy and survival. An average weight loss of 5-10% of total body weight loss improves overall fitness, better blood sugar control, decreases the need for medications and reduces the risk of heart disease.
Management of obesity depends on the grade or the severity of the disease.
Patients with a Body Mass Index (BMI) between 23.5 to 27.5 Kg/m2 fall in the overweight category. These patients can achieve weight loss with a healthy diet and lifestyle modification. Some tips for a shift to a healthier diet are:
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Patients with a BMI between 27.5 to 32.5 Kg/m2 come under Grade 1 obese category. These patients can also benefit from diet and lifestyle modification as discussed above. There is a role of weight loss medications as well for these patients which can be prescribed after discussion with the treating diabetologist/endocrinologist. It is important to keep a tab on the blood sugar levels and close monitoring must be done. Patients in this category may also benefit from endoscopic weight loss therapies if other conservative methods of weight loss are not effective.
Patients with a BMI between 32.5 to 37.5 Kg/m2 come under Grade 2 obese category. In addition to diet and lifestyle modification, drug therapy and endoscopic therapies, metabolic surgery may also be considered for treatment of obesity and type 2 diabetes. Metabolic surgery can lead to prolonged remission of diabetes and delay the onset of micro- and macro-vascular complications of type 2 diabetes. Patients with a BMI more than 37.5 Kg/m2 fall in the grade obesity category and benefit significantly with bariatric/metabolic surgery. Surgery not only leads to weight loss, but it also leads to a quick remission of diabetes.
With rising levels of obesity and type 2 diabetes, it is the need of the hour to have combined treatment strategies and focus on both. Weight management is an integral part of diabetes management. With a graded treatment approach as per the severity of the disease, we can help our patients to lead a healthier life.
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