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Obesity and Type 2 Diabetes: Epidemiological Evidence

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Many cross-sectional and prospective studies have confirmed the link between obesity and type 2 diabetes. Most individuals with type 2 diabetes are overweight or obese. Studies suggest that about 60-90% of all patients with type 2 diabetes are or have been obese (10, 11). One of the first observations on the association between obesity and type 2 diabetes was published by John in 1929 (15). In the 1960s, the seminal population studies of West and Kalbfleisch (16) demonstrated the strong association between overweight and diabetes. They reported that a population’s degree of obesity was the key environmental factor influencing diabetes prevalence reverses diabetes type 2 in children (☑ vitamins) | reverses diabetes type 2 overweighthow to reverses diabetes type 2 for (17)(17). Similarly, a study conducted in the Pima Indian population—a community at high risk of type 2 diabetes—revealed that the probability of developing type 2 diabetes rose with increasing body mass index (BMI) (18). More recently, data from the Third National Health and Nutrition Examination Survey (NHANES III) (19) showed a strong increase in type 2 diabetes among both overweight and obese men and women with increasing weight classes. Recent prospective studies have also tied increasing weight to an increased risk of type 2 diabetes. For instance, the Nurses’ Health Study (20)—a 14 year follow-up study of 11,824 women aged 30-55 years—found the risk of developing type 2 diabetes was 49 times higher among women whose baseline BMI was >35 kg/m2 than among women whose baseline BMI was <22 kg/m2 (Figure). The risk of developing the disease increased fourfold when BMI was between 23.0 and 25.0 kg/m2 and even lean women with a BMI of 22.0 to 22.9 kg/m2 had a significant threefold increase in their risk of type 2 diabetes compared to women with a BMI <22.0 kg/m2. They also found that weight gain of 7.0 to 10.9 kg after the age of 18 was associated with a twofold increase in the risk of type 2 diabetes, the increase in risk being proportionate to the degree of weight gain.


Reference
10. Halpern A and Mancini MC. Diabesity: are weight loss medications effective? Treat Endocrinol 2005; 4: 65-74.
11. Stumvoll M, Goldstein BJ and van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet 2005; 365: 1333-46.
15. John H. Summary of findings in 1100 glucose tolerance estimations. Endocrinology 1929; 13: 388-92.
16. West KM and Kalbfleisch JM. Glucose tolerance, nutrition, and diabetes in Uruguay, Venezuela, Malaya, and East Pakistan. Diabetes 1966; 15: 9-18.
17. West KM and Kalbfleisch JM. Influence of nutritional factors on prevalence of diabetes. Diabetes 1971; 20: 99-108.
18. Knowler WC, Pettitt DJ, Savage PJ, et al. Diabetes incidence in Pima indians: contributions of obesity and parental diabetes. Am J Epidemiol 1981; 113: 144-56.
19. Must A, Spadano J, Coakley EH, et al. The disease burden associated with overweight and obesity. JAMA 1999; 282: 1523-9.
20. Colditz GA, Willett WC, Rotnitzky A, et al. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med 1995; 122: 481-6.
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