Tuesday July 17, 2018

Dumaguing: Are obesity and diabetes relatives?

DEAR readers and friends, the issue was posited as a question, otherwise the Father of Heredity, Gregor Mendel might be turning in his grave in a violent aggressive reaction. As mentioned in my previous article, our Baguio doctors who went to diabetes conferences in Portugal and Denmark came hoe with the same disturbing news about the increasing incidence of this metabolic malady; more disturbing by the fact that more and more patients are diagnosed in the so-called Third World developing countries where comprehensive health service leaves so much to be desired.

World Health Organization (WHO) figures show that the number of people with diabetes has soared from 108 million in the 1980s to 422 million in 2014. d take note, almost in the same period, the obesity rate has doubled to less than 1,.9 billion overweight adults, of which 600 millions are obese. Thus, the stark reality is that, obesity and diabetes are linked together; that is, excess weight in the form of body fat, can lead to diabetes, with the emphasis that 90 percent of type 2 diabetics have problems maintaining a healthy ideal body weight.

The diagnosis of obesity may vary from one country to another, or perhaps the better word is from race to race. For most Asians, with the possible exception of the leaner Japanese, a body mass index of 25 and above or a waist circumference of at least 31 inches for the women and 35 inches for men. Body mass index (BMI) is derived from one body's weight in kilograms (l kilo = 2.2 lbs) divided by the square of the height of the patient in meters. In the Philippines, as of today, 6 million are diabetics with a third of our population either overweight or obese.

The whole world paused and held their breath when the American Medical Association officially recognized obesity as a disease thus international organizations like American Diabetes Association, European Association for the Study of Diabetes, International Diabetes Federation started a unified frenzied collective effort to disseminate information about the very close link between obesity and diabetes. Even our Filipino endocrinologists and diabetologists made sure that obesity and excess weight are included in the core topics during their respective conventions.

Several mechanisms have been forwarded as to how obesity easily leads to a diabetic state. It appears that fatty tissues secrete a substance called "resistin," what a convenient term, that may make the receptors for the hormone insulin found in skeletal muscles - which form 45 to 50 percent of our body mass - insensitive to it thus, glucose transport.

into the cell by insulin is not done, thus, hyperglycemia-high blood sugar - and later on glycosuria - high urine sugar-occur.

Of course, there are other clinical complications of obesity, which will be discussed in future issues. Exercise, exercise-your doctors and even our friends tell us. Diet, diet- the same people tell us, repetitively. Sad to say, the spirit is willing but the body is weak. Let's not wait for New Year to make a resolution. Move, move and move some more, loss 1-2 lbs per week, and hopefully, your blood sugar will behave!