Type II Diabetes and Obesity
By Claudette Nazaryan, M.S.
Diabetes is a carbohydrate, fat and protein metabolism disorder that leads to elevated glucose levels; and increased risk of cardiovascular disease, renal disease, and peripheral neuropathy. In type II diabetes the cells of the body become resistant to insulin, meaning that glucose cannot get into the cells, thus the blood glucose levels become elevated. The classic symptoms of diabetes are frequent urination and increased thirst and appetite.
Obesity is a major contributing factor to the loss of insulin sensitivity.
About 90% of the people with type II diabetes are obese (BMI over 30).
As the size of adipocites (fat cells) increases (more fat accumulates in them), they produce certain substances, such as leptin and resistin, that make the cells resistant to insulin, stimulate the liver to produce more glucose, reduce insulin production, and interfere with the utilization of glucose by the skeletal muscle. The later may contribute to loss of muscle, thus the reduction of body's fat burning ability.
Moreover, as the size of the adipocites increases, they fail to produce certain hormone-like compounds (e.g. adiponectin), which improve insulin sensitivity. In addition to improving insulin sensitivity, adiponectin also has anti-inflammatory properties, and lowers triglycerides (often elevated in type II diabetes). All of these functions of adiponectin significantly reduce the risk of atherosclerosis (hardening of the arteries).
At the beginning stages of insulin resistance (caused by the products of adipocites and the lack of adiponectin) blood glucose levels remain normal, since the pancreas produces more insulin, which helps transport the excess glucose into the cells. But later, as the insulin resistance increases, the pancreas cannot compensate, so blood sugar levels become elevated. And as the disease progresses further, the insulin producing capacity of the pancreas decreases and insulin levels drop. Low insulin levels combined with insulin resistance may increase the glucose levels further, making diabetic complications more serious.
Weight loss almost always results in the regulation of blood glucose and insulin levels, and dramatically reduces all the health hazards associated with the disease. Even a modest weight loss has beneficial effects.
So, nutritional and exercise program designed to reduce body fat and increase muscle mass will greatly improve insulin sensitivity and restore blood glucose levels, thus helping avoid diabetic complications.
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