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Written By

Katherine Kokkonen


College of Medicine and Dentistry

Publish Date

9 May 2019

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A global problem

We are in the midst of a pandemic and most of us don’t even know it. Around 422 million adults around the world have diabetes and the number is rising. An overweight person with type 2 diabetes has a reduced life expectancy, as well as reduced quality of life. What can be done to tackle diabesity?

Diabetes has almost become so common that we no longer pay attention to the serious risks the chronic disease can pose. If you have diabesity, that is if you have type 2 diabetes and are overweight or obese, you have an even greater risk of stroke, blindness, heart attack, kidney failure or amputation. JCU’s Dr Roy Rasalam has a special interest in diabetes and its complications. He wants people to know that while the risks are serious, the disease can be managed.

“I have been managing patients with diabesity for more than 20 years,” he says. “My aim is to educate and empower patients to take control of their chronic disease and reduce their risk of complications.”

If you are overweight or obese, you have a greater risk of developing type 2 diabetes. Obesity is when you have a body mass index (BMI) greater than 30. Your BMI is an estimate of your body fat and is calculated by dividing your weight (in kilograms) by your height (in metres) and then dividing that answer by your height again. Between 80 to 90 per cent of people with type 2 diabetes are overweight or obese.

“Obesity is a chronic disease with many complications, including type 2 diabetes,” Roy says. “Many patients with type 2 diabetes remain undiagnosed. It’s estimated that around 500,000 people in Australia are undiagnosed. Please see your doctor for a diabetes risk screen, especially if you are overweight or obese.”

Weight matters when it comes to diabetes. When the body has excess fat, especially in muscle and adipose tissue, it leads to insulin resistance. Insulin is the hormone that enables glucose to enter cells. When insulin resistance occurs, the pancreas kicks in and produces more insulin to try and manage blood glucose levels. The body’s ineffective use of insulin results in that person developing type 2 diabetes.

obese woman exercising
Bariatric surgery being performed in an operating theatre

Managing a chronic disease

While the most effective treatment for diabesity is bariatric surgery, undergoing such treatment is expensive and might result in surgical complications.

Roy says most people with diabesity require a comprehensive treatment strategy, which a team of health professionals should develop.

“A doctor is only one member of that team,” he says. “Other team members may include a dietitian, a diabetes educator, an exercise physiologist and a health psychologist. This team can develop a strategy that focuses on lifestyle modifications, such as a healthy diet and increased physical activity, medications and, if applicable, identification and treatment of any underlying anxiety or depression. Healthcare professionals should also spend time explaining to their patients about how this is a chronic disease, not a lifestyle problem.”

While diabesity has no cure, proper management of the disease can cause it to go into remission. Losing weight can also prevent or delay progression of type 2 diabetes by up to 60 per cent.

“If a person is overweight or obese, modifying their lifestyle is the best thing they can do to reduce their risk of developing type 2 diabetes,” Roy says. “This means weight reduction through healthy diet and increased physical activity.”

To find out more from Dr Roy Rasalam, follow him on Twitter @RoyDiabetesDoc.

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