Diabesity

     The term 揹iabesity?was coined to emphasize the very strong link between diabetes and obesity. Diabetes afflicts almost 24 million Americans and is the leading cause of blindness and kidney disease. An additional 57 million have 損re-diabetes?with higher than normal blood glucose levels and are at risk of developing diabetes. The overall risk of dying doubles if one has diabetes and there is a two to four times risk of having a stroke or dying from heart disease. Diabetes is currently the number one direct health care cost with one of every seven health care dollars spent treating patients with diabetes.

Ninety percent of diabetics are 搕ype 2?defined as insulin resistance with eventual failure of the pancreas to produce insulin. The number one cause of type 2 diabetes is excess weight accounting for 97% of cases and roughly 95% of patients with type 2 diabetes are obese defined as having a body mass index (BMI) of at least 30 kg/m2. Obesity is now a worldwide pandemic afflicting 34% of the United States with a steady rise over the last thirty years. Obesity, itself, accounts for over 100 billion healthcare dollars spent per year and is now the leading cause of 損reventable?death with approximately 300,000 deaths per annum in the U.S. Because diabetes and obesity are so closely linked involving many of the same patient population, the approach to treatment involves addressing the diabesity epidemic. Losing weight leads to improvement and often remission of diabetes.

It is important to know one抯 body mass index (BMI) as this not only determines whether one is of normal weight, overweight or obese; but it also provides some risk assessment for developing many of the obesity-related medical diseases including type 2 diabetes. There are many web-based BMI calculators that easy to use to determine one抯 BMI. A BMI between 19 and 25 is considered normal weight for one抯 height while the 25 ?30 range indicates overweight and above 30 is obesity. Morbid obesity, defined as a BMI above 40, indicates a three-fold risk of dying compared to a normal weight person. The risk of developing type 2 diabetes rises by 25% for each BMI unit above 22.

For patients with type 2 diabetes, losing weight is an integral part of the treatment. Bariatric surgery to treat obesity has been performed since the 1960抯 and not does not only lead to permanent and significant weight loss, but improvement and often remission of the many obesity-related medical problems including diabetes. Long-term remission defined as normal blood glucose off medications is achieved in obese diabetics undergoing bariatric surgery in 60 ?90% of patients depending primarily on the surgical procedure. A recent meta-analysis of the medical literature including 621 studies and 135,246 patients showed a complete remission of diabetes in 78.1%. The American Diabetes Association 2009 Recommendations specifically endorsed bariatric surgery for diabetics with a BMI of at least 35.

Diabesity is not only treatable but patients can potentially achieve long-term remission off all medications with bariatric surgery.

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