Obesity and prediabetes are two increasingly common and interconnected health problems in modern society. Understanding how these two conditions influence each other is essential for effective management, he explained to us Dr. Sabina Poenar in the material made for Rodiabet.ro.
prediabetes it is an intermediate stage between a normal blood sugar level and type 2 diabetes. It is often overlooked because it has no obvious symptoms, but it is a warning signal for the increased risk of developing type 2 diabetes.
Numerous factors increase the risk of prediabetes, especially those that contribute to insulin resistance:
- High body mass index (BMI), over 25 kg/m2
- Sedentary lifestyle, defined by less than 4,000 steps per day
- Old age, especially over 65 years
- Family history of diabetes or prediabetes
- The presence of other conditions such as polycystic ovary syndrome, hypothyroidism, high blood pressure and an increased level of triglycerides
- Certain medications: steroids, psychiatric medications, or oral contraceptives.
The diagnosis of prediabetes
The diagnosis of prediabetes is based on specific tests:
- Fasting blood glucose (fasting): A blood sugar after an eight-hour fasting period with values between 100-125 mg/dL indicates prediabetes.
- Hemoglobin A1C: An interval between 5.7% – 6.4% means prediabetes.
- The oral glucose tolerance test: If the blood sugar level is 140 to 199 mg/dL 2 hours after taking 75g of glucose, then the test indicates prediabetes.
Obesity as a trigger for prediabetes
Traditionally, obesity is seen as a result of consuming too many calories in relation to the body’s needs, causing excessive fat accumulation and increased blood glucose levels. However, this simplistic approach does not cover the complexity of the mechanisms involved.
Obesity, especially fat storage around internal organs, contributes to insulin resistance, where cells become less sensitive to its action, causing blood glucose levels to rise. In this context, adipose tissue releases free fatty acids in high amounts, triggering systemic inflammation and insulin resistance.
Chronic inflammation associated with obesity can also negatively affect pancreatic beta cells, contributing to the development of prediabetes.
Fat cells also produce inflammatory substances that interfere with insulin signaling such as tumor necrosis factor-α and interleukin-6 affecting glucose metabolism and contributing to this vicious cycle. Thus, obesity is not only the result of a caloric imbalance, but also the result of adipose tissue dysfunction and inflammation.
Prediabetes as a trigger for obesity
Contrary to the traditional model, which focuses on caloric intake, eating processed foods with a high glycemic index causes sudden spikes in blood sugar levels. This causes the pancreas to release insulin to help cells take up glucose.
However, regular consumption of these foods leads to persistently elevated insulin levels, which promotes fat storage. Insulin has a lipogenic effect, stimulating the conversion of excess glucose into fat to form deposits. High insulin levels also suppress the release of appetite-regulating hormones, leading to increased hunger and overeating.
People with prediabetes may experience increased hunger and changes in metabolism, leading to weight gain. Leptina hormone secreted by fat cells, regulates hunger, but in prediabetes, leptin resistance can disrupt satiety signals, causing people to eat more and gain weight.
Therefore, prediabetes, characterized by insulin resistance and elevated insulin levels, creates a metabolic environment conducive to weight gain and obesity. As blood sugar levels rise, so can body weight.
Treatment strategies
- Nutritional therapy: This involves identifying and adjusting food intake, with an emphasis on reducing the consumption of foods with a high glycemic index. Thus, the stabilization of the blood sugar level is promoted.
- Physical exercise: Integrating regular physical activity is essential to increase insulin sensitivity and promote weight loss. Walking is an excellent example of exercise, and the recommendation is to walk at least 6 kilometers every day.
- Medication: In some situations, medications may be prescribed to regulate blood sugar levels and manage prediabetes. These drugs are used to reduce insulin resistance.
- Regular blood glucose monitoring: Regular monitoring of fasting blood glucose and hemoglobin A1C levels is important to detect early changes and prevent progression to diabetes.
Conclusion
Understanding the correlation between obesity and prediabetes is crucial to implementing effective preventive measures and improving our long-term health. By adopting a healthy lifestyle that includes a balanced diet, regular exercise and careful health monitoring, we can reduce the risk of serious complications associated with prediabetes and obesity. Consulting and following your doctor’s advice is essential to managing and preventing these conditions.
Text made by Dr. Sabina PoenarDiabetes, Nutrition and Metabolic Disease Resident Physician, SCOPE Internationally Certified in Obesity Management, for the platform DIABETES. You can find more interesting materials about diabetes on the social accounts of Dr. Sabina Poenar: linkedin.com/in/sabina-poenar-60a56b186 and https://www.instagram.com/sabina_poenar/.
Bibliography:
https://woodlandsweightcenter.com/blog/pre-diabetes-and-obesity
Khaodhiar, Lalita et al. “Treating diabetes and prediabetes by focusing on obesity management.” Current diabetes reports vol. 9.5 (2009): 348-54. doi:10.1007/s11892-009-0055-0
