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Journal of Diabetology | Volume 3
Page 26
July 25-26, 2019 | Amsterdam, Netherlands
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
alliedacademies.comYEARS
Diabetes Conference 2019
3
rd
International Conference on
DIABETES, NUTRITION,
METABOLISM & MEDICARE
DIABETES, OBESITY ANDWEIGHT LOSS
Lama Alnaeli
Wellness By Design - Dubai
I
n the US a study have been done to estimate the prevalence of obesity and diabetes among US adults. The
study was done on random f 195005 adults aged 18 years or older residing in all states. The main outcome
measures the body mass index, based on self-reported weight and height and self-reported diabetes. The re-
sults came as follow: The prevalence of obesity (BMI ≥30kg/m2) was 20.9% (An increase of 5.6%) and the prev-
alence of diabetes increased to 7.9, (An increase of 8.2%). Overweight and obesity were significantly associated
with diabetes, high blood pressure, high cholesterol, asthma, arthritis and poor health status. Increases in obe-
sity and diabetes among US adults continue in genders, all ages, all races, all educational levels and all smoking
levels. Obesity is strongly associated with several major health risk factors. In another study they analysed data
from a cohort of 51,529 US male health professionals, 40-75 years of age, who completed biennial question-
naires. During five years of follow-up 272 cases of noninsulin-dependent diabetes mellitus (NIDDM) were diag-
nosed among men without a history of diabetes, heart disease and cancer and who provided complete health
information. Relative risks (RRs) associated with different anthropometric measures were calculated controlling
for age and multivariate RRs were calculated controlling for smoking, family history of diabetes and age. They
found a strong positive association between overall obesity as measured by body mass index (BMI) and risk of
diabetes. Men with a BMI of ≥35 kg/m2 had a multivariate RR of 42.1 compared with men with a BMI <23.0 kg/
m2. BMI at age 21 and absolute weight gain throughout adulthood were also significant independent risk fac-
tors for diabetes. Fat distribution, measured by waist-to-hip ratio (WHR) was a good predictor of diabetes only
among the top 5%, while waist circumference was positively associated with the risk of diabetes among the
top 20% of the cohort. These data suggest that waist circumference may be a better indicator thanWHR of the
relationship between abdominal adiposity and risk of diabetes. Although early obesity, absolute weight gain
throughout adulthood and waist circumference were good predictors of diabetes, attained BMI was the domi-
nant risk factor for NIDDM; even men of average relative weight had significantly elevated RRs. Further studies
have been done on individuals who have progressed to pre-diabetes. A Finnish Prevention study and the dia-
betes prevention program showed conclusively that intensive lifestyle interventions decreased the overall risk
of diabetes by 58%. Lifestyle interventions included a weight reduction of 5% or more, reduction of total fat
intake to <30% of total calories and increased physical activity (≥4 hours/week). Even more encouraging is the
report from the Finnish Prevention Study follow-up period averaging seven years, in which the intervention
group saw a 43% reduction in risk of diabetes. A study shows that achievable weight loss has a modest effect
on A1C levels. However, in several other studies, weight loss was not associated with improvement in glycae-
mia. Furthermore, other nutrition therapy interventions that tend to focus more on metabolic control and
less on weight loss have been shown to improve A1C levels by 1–2%. It is likely that early in the course of the
disease process, when insulin resistance is still prominent, either energy restriction or weight loss will improve
blood glucose levels. But as the disease progresses and insulin deficiency becomes more prominent, it may be
too late for weight loss to be helpful. In fact, at later stages of the disease, when medications, including insulin,
need to be combined with nutrition therapy, prevention of weight gain often becomes the goal. However,
glycaemic control should take precedence over concerns about weight.
J Diabetol 2019, Volume 3