World Diabetes Day 2024, Diabetes risk and obesity: Diabetes continues to be one of the leading communicable diseases globally. Doctors maintain that obesity and diabetes are closely linked, often forming a cycle that can be challenging to break.

Several studies suggest that obesity, marked by excessive body fat, increases the risk of developing type 2 diabetes because excess fat, particularly around the abdomen, can make cells less responsive to insulin, the hormone that regulates blood sugar. This leads to insulin resistance, where the body needs more insulin to keep blood glucose levels in check, eventually resulting in high blood sugar and type 2 diabetes.

According to Dr. Vahid S. Bharmal is consultant- adult & paediatric endocrinologist at the Bhailal Amin General Hospital in Vadodara, excess weight, particularly from body fat, significantly increases the risk of insulin resistance, leading to type 2 diabetes and various metabolic complications.

“In individuals with obesity, the excess adipose tissue leads to a state of insulin resistance, which imposes stress on pancreatic beta cells responsible for insulin production. This stress contributes to the progression of insulin resistance into full-blown diabetes over time. Obesity is also associated with generalized low-grade inflammation, as adipose tissue releases inflammatory cytokines. This inflammation exacerbates insulin resistance, as does the elevation of free fatty acids in the bloodstream, which is common in obesity. These factors contribute to the increased difficulty in regulating blood glucose levels, further stressing beta cells and raising the risk of metabolic diseases,” Dr. Bharmal told Financial Express.com.

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The long-term consequences of this metabolic dysfunction are extensive. Metabolic syndrome, a cluster of conditions including insulin resistance, hypertension, and abnormal lipid levels, substantially raises the risk of developing type 2 diabetes mellitus.

“It also increases the likelihood of hypertension and cardiovascular diseases, including heart attack and stroke, due to the added stress on blood vessels and the heart. Additionally, obesity-related insulin resistance is a risk factor for metabolic-associated fatty liver disease, where fat accumulates in the liver, leading to liver damage,” Dr. Bharmal said.

Other health complications arising from metabolic syndrome include obstructive sleep apnea, due to the impact of excess weight on breathing patterns; polycystic ovary syndrome (PCOS), linked to hormonal imbalance; and a heightened risk of certain cancers, notably breast, colon, and liver cancers.

He also said that the interplay of inflammation, hormonal disruptions, and metabolic dysfunction in obese individuals accelerates the progression of these diseases, underscoring the importance of managing weight to prevent the cascade of metabolic and health-related issues associated with obesity.

Meanwhile, Dr. Kedar Patil, Bariatric and Advanced laparoscopic Surgeon at Ruby Hall Clinic revealed that weight gain can significantly impact blood sugar levels, particularly in individuals with metabolic syndrome.

Here’s how:

  • Insulin Resistance: Increased body fat, especially around the abdomen, can lead to insulin resistance. This means that the body’s cells become less responsive to insulin, making it harder for glucose to enter the cells and thereby raising blood sugar levels.
  • Increased Free Fatty Acids: Weight gain often leads to higher levels of free fatty acids in the bloodstream. These can interfere with insulin signaling pathways, further exacerbating insulin resistance.
  • Inflammation: Excess weight is associated with chronic low-grade inflammation, which can damage insulin-producing cells in the pancreas and contribute to higher blood sugar levels.
  • Hormonal Changes: Weight gain can alter hormone levels, including increasing the production of hormones like cortisol and decreasing adiponectin, which play roles in insulin sensitivity.
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Long-term Consequences for Individuals with Metabolic Syndrome:

  • Increased Risk of Type 2 Diabetes: Prolonged insulin resistance can lead to the development of type2 diabetes, which is characterized by elevated blood sugar levels.
  • Cardiovascular Disease: Individuals with metabolic syndrome are at a higher risk of cardiovascular issues due to factors like hypertension, high cholesterol, and elevated blood sugar.
  • Other Complications: Chronic high blood sugar levels can lead to complications such as neuropathy, retinopathy, and nephropathy, all of which can significantly impact quality of life.
  • Worsening Metabolic Syndrome: Weight gain can lead to a worsening of metabolic syndrome, leading to a vicious cycle where increased blood sugar and other metabolic abnormalities further promote weight gain.