Obesity and Type2 Diabetes

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A strong association between indices of overweight and obesity and the development of type-2 diabetes has been reported in a great many studies. As

Fig. 2. Body mass index (BMI) and the age-adjusted relative risk (95% confidence interval) for non-insulin-dependent diabetes in US women.

one example, Colditz et al. [9] followed women, 30-55 years of age, over 14 years. They demonstrated that the risk of developing type-2 diabetes increased rapidly with increases in body mass index (BMI; fig. 2). Individuals with BMIs in the healthy range (18.5-24.9 kg/m2) were at very low risk of developing type-2 diabetes. Also, weight gain in adults, regardless of BMI, appears to be a risk factor for development of type-2 diabetes [9, 10].

Since overweight and obesity increase the risk of development of type-2 diabetes, the next question is whether weight loss in these groups reduces the risk of development of type-2 diabetes. Strong evidence in support of weight loss as a means of preventing type-2 diabetes in individuals who are overweight or obese comes from the Diabetes Prevention Program (DPP) [11] and from the Finnish study on the prevention of type-2 diabetes [12]. In these studies, overweight and obese individuals, who were at high risk of developing type-2 diabetes (i.e. impaired glucose tolerance) and who were assigned to a lifestyle-intervention program that involved modest weight loss, reduced their risk of developing type-2 diabetes by about 60%. In the DPP, the lifestyle group achieved a 7% reduction in body weight and maintained a 5% weight reduction over 4 years. The lifestyle intervention in the DPP included modification of diet and increases of 150min/week of physical activity.

In summary, the available data suggest that increases in body weight that lead to overweight and obesity increase the risk of type-2 diabetes. Modest weight loss in overweight and obese individuals substantially reduces the risk of type-2 diabetes.

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