Obesity and type 2 diabetes, two potentially debilitating conditions, are fueling a new one-plus-one-equals-three epidemic of what some clinicians and medical researchers have termed “diabesity.”
“It’s a term that emphasizes the fact that type 2 diabetes is often associated with obesity,” said Professor Juergen Naggert, who has spent years researching the genetic components of both diseases at The Jackson Laboratory in Bar Harbor. “It requires that you have mutations of both obesity genes and diabetes susceptibility genes.”
“That’s not a term I’ve heard, but it certainly fits what type 2 diabetes is all about,” said Dr. Jonathan Fanburg, a pediatrician and adolescent medicine specialist at Maine Medical Center’s pediatric clinic in South Portland.
U.S. Centers for Disease Control and Prevention statistics show that while only 7 percent of obese people will develop type 2 diabetes, about 90 percent of those with type 2 diabetes are obese. Of particular concern to public health officials is the growing number of overweight children and adolescents who are being diagnosed with what was, until recently, termed “adult-onset” diabetes.
“In Maine we’ve recently seen some leveling off with childhood obesity, but it’s still a problem,” Fanburg said. “And type 2 diabetes is definitely a problem. A lot of things drive it: the environment, genetics and the culture that kids experience.”
While the CDC doesn’t have state or national data on the prevalence of type 2 diabetes in children, it estimates that 210,000 diabetics are under age 20 and that many thousands more are diabetic but haven’t been diagnosed.
There are two forms of diabetes, both related to the body’s ability to generate and process insulin, a hormone produced in the pancreas that regulates how cells in the body convert blood sugar into energy.
Type 1 diabetes is an autoimmune disease in which the body destroys insulin production by the pancreas, requiring daily insulin injections. Type 2 diabetes accounts for about 95 percent of all diabetes. For reasons largely unknown, type 2 diabetics are unable to effectively use the insulin their bodies produce.
Diabetes is the seventh leading cause of death in America, a ranking that many clinicians feel is understated. Insulin resistance puts type 2 diabetics at greater risk for heart disease, high blood pressure, stroke, kidney disease, nerve damage, amputations and blindness.
Underlying much of the increase in type 2 diabetes, the CDC says, is the grim reality that Americans are fat and getting fatter. Two out of three adults in America are overweight or obese, based on body mass index measurements. So are one in three children and adolescents, as the incidence of childhood obesity has more than tripled in the last 30 years.
Among high school students in Maine, 12 percent were overweight in 2011.
Fanburg said he has witnessed a “change in Maine’s culture” that makes him optimistic that fewer of the state’s children and teens will have to cope with type 2 diabetes and other medical issues related to obesity.
“What’s really helped is the success of the simple messaging of ‘5-2-1-0.’ About any kid I might encounter can tell me what that means.”
The “5” stands for five daily servings of fruits and vegetables, he said, and the “2” for limiting TV and other “screen time” to two hours a day. The “1” encourages at least one hour or more of physical activity a day, while the “0” reminds kids to not consume any sugar-laced drinks and to drink more water and low-fat milk every day.
Dr. Dora Anne Mills, a pediatrician who between 1996 and 2011 was the director of the Maine Center for Disease Control and Prevention, said interventions such as 5-2-1-0 are helping to build public awareness of obesity and sedentary lifestyles as contributors to disease and disability.
“It’s taken decades for the United States and Maine to build obesity into the fabric of our society,” said Mills, now the director of public health programs and vice-president of clinical affairs at the University of New England in Portland. “And I suspect it will take decades to build health into the fabric of our society. We have a long, long way to go.”
Do you have diabesity?
If you answer yes to any of these questions, you may already have diabesity or are headed in that direction.
- Do you have a family history of diabetes, heart disease or obesity?
- Are you of nonwhite ancestry (African, Asian, Native American, Pacific Islander, Hispanic, Indian, Middle Eastern)?
- Are you overweight (BMI or body mass index over 25)?
- Do you have extra belly fat? (Is your waist circumference greater than 35 inches for women or greater than 40 inches for men?)
- Do you have sugar and refined carbohydrate cravings?
- Do you have trouble losing weight on a low-fat diet?
- Has your doctor told you your blood sugar is a little high or have you actually been diagnosed with insulin resistance or pre-diabetes?
- Do you have high levels of triglycerides or low HDL (good) cholesterol?
- Do you have heart disease?
- Do you have high blood pressure?
- Are you inactive (less than 30 minutes of exercise four times a week)?
- Have you had gestational diabetes or polycystic ovarian syndrome?
- Do you suffer from infertility, low sex drive, or sexual dysfunction?
Source: Dr. Mark Hyman, author of “The Blood Sugar Solution”
Type 2 diabetes and obesity being connected is not a surprise given Americans eating habits. Healthier eating can help even with a genetic component. Mostly, I feel badly for children who are obese while being caught up in the high calorie and high fat diets in America.
I think of type 2 diabetes as more of a saturation of the body, which is why people are obese, and when they lose fat they lose diabetic symptoms.
Although, I do not believe all older people develop that type of diabetes. I know thin older people whose bodies no longer handle sugar and slowly got worse as they aged like their bodies stop producing as much insulin???
And, not all obese people have or develop diabetes.
Amen to that. Look at any shopping cart the next time you go to the grocery store and compare the amount of fruits/veggies/whole grains to prepackaged foods. Yes, there are more boxed and prepared foods nowadays that are healthy but the rule of thumb is to try and buy food in it’s most natural state. And don’t get me started on “eating healthy costs too much” because the more healthy and nutrient-packed the food is, the less you need to eat to be satisfied, and the less medication/hospitalizations/etc. you will have–costing everyone much less in the long run.
Diabetes type II is a purely diet related disease, along with most high cholesterol.
Two years ago I was diagnosed with both Diabetes Type II and high cholesterol and with medication I was barely able to control either one. I changed to a whole food, plant based diet, meaning I eat fruits, vegetables, whole grains and legumes and no meat, dairy, processed foods or refined sugar. Within 4 months I was cured from both Diabetes Type II and high cholesterol by my doctor, who was surprised as all h*ll that I was cured.
Good for you! I can surely sit back and take comfort in the fact that I will always have a job as a nurse because of our high rates of obesity and all the medical complications that go with it. Unfortunately, not all have your will and attitude and would rather take a pill or “just a little extra insulin so I can have that piece of chocolate cake”. People also need to be accountable for their own health and we as healthcare providers need to educate patients on proper diet and exercise and how to make healthy food taste good. But really, I think most people have the idea that you need to burn more calories than we take in so in the end it’s sheer laziness or lack of will-power. Continue telling others your story. At least one person will be inspired and follow suit.
Thanks :) but it was actually easy once I decided that I didn’t want to keep taking pills the rest of my life.
Fanburg said he has witnessed a “change in Maine’s culture” that makes him optimistic that fewer of the state’s children and teens will have to cope with type 2 diabetes and other medical issues related to obesity.~~~~~Hey, UMaine-you’re so intent on making sure people are healthy on campus (at least not smoke or chew), what are you doing about this with the University’s culture? Selling junk food and deep friend food and telling students not to worry when they gain the “freshman 15,” isn’t quite in line with your supposed mission.
Really? I got the freshmen -5 with all that campus food. Ick.
I think the one hour of physical exercise should be better explained. If one goes out and runs hard for an hour every day they could get injured or be prone to injury, and increase their risk of a heart attack.
I think the exercise they are referring too is low moderate activity where the heart rate is elevated over a resting rate, but below a workout zone, or as some athletes have heard, zone 2 or 3. It’s ok to go into those higher zones say above 120, but not necessarily for too long as it increases heart attack risk. It also increases stress and reduces bone density too, increasing the risk of injury.
Stretching, slow activity, walking……
A little stress though is good, it can help lower cholesterol since cortisol, a stress hormone is synthesized from cholesterol. High intensity workouts also burn fat faster. I could use more info on the protein burning zone. Fats are often stored with or near protein and go right into make energy like sugar.
Another thing not mentioned in the equation is meditation, which lowers the heart rate, so both the heart and blood vessels get some rest. It helps retain their elasticity.
Mainecitizen, that is absolutely not always true that you increase your risk of heart attack of you exercise for an hour straight. Now, someone who is not in shape/overweight or who has a medical condition should not jump into intense exercise and certainly shouldn’t do so until checking with their healthcare provider. But intense exercise for most people strengthens the heart and lungs, burns calories, increases endurance-which has been proven to decrease sensitivity to insulin (good for diabetics), and has all kinds of other benefits.
Even people with heart failure or heart disease can improve their heart function and with training, their heart eventually needs less oxygen to function appropriately.
I’d like to see where you get your evidence regarding elevated heart attack risk (other than those severely out of shape or those with a medical conditions) from intense exercise and elevated heartrate. Actually, the more out of shape you are, the higher your risk of hurting yourself so that should be incentive enough for people to start exercising.