Everyone's Health

The link between obesity, diabetes

It is important that you have a basic understanding of the relationship between obesity, insulin and diabetes.

During digestion, most carbohydrates are broken down into their glucose building blocks. The glucose is then absorbed into the blood stream, at which point it is often referred to as blood sugar.

Glucose needs to get into the cells, but it has a hard time doing this on its own. The missing factor is insulin, the hormone released by the pancreas as the blood glucose level rises. Insulin functions like a passport to get the glucose into the cells.

Once inside the cells, glucose can be used to provide energy for work, such as muscular efforts or cellular repair. When there is sufficient energy, the glucose gets changed into fat, the body's most concentrated form of energy, and put away in storage.

Diabetes is present when there's insufficient insulin to get the glucose out of the blood and into the cells. Type 1 diabetes is when the pancreas is unable to produce insulin. In such cases, insulin needs to be provided via injection. It has to be given that way because if insulin were taken orally, the digestive system would break it down before it could be absorbed.

More common is Type 2 diabetes; this occurs when the pancreas is still able to produce insulin but can't keep up with the demand, and the blood glucose level remains elevated. Treatments can include diet and lifestyle adjustments, or medications to stimulate the pancreas to release more insulin.

Type 2 diabetes used to be known as “adult onset” diabetes because it was only seen in adults. With the increasing prevalence of obesity in children, we are now seeing cases of Type 2 diabetes in children.

The connection with obesity relates to the fact that as a person gains weight, the fat cells increase in size. Scientists have learned that enlarged fat cells are associated with a decreased sensitivity to insulin.

This insulin resistance means that the body needs more insulin to clear the same amount of glucose out of the blood stream. The obesity, in essence, overworks the pancreas and eventually, it is unable to keep up.

Between 80 percent and 90 percent of those with Type 2 diabetes are obese. This also helps explain why those with Type 2 diabetes often experience dramatic improvements when they lose a few of their excess pounds.

As there can be short-and long-term complications when the blood glucose remains elevated, the goal is to keep the glucose level within normal limits. This can be done with diet, exercise, medication and insulin injections. Along with this goes regular monitoring of the blood glucose level.

I would encourage you to speak with your physician and a registered dietitian. They can help you map out strategies for weight loss and food selection. It may also help to contact your local chapter of the American Diabetes Association. To find the chapter in your area, call (800) 232-3472 or check online at www.diabetes.org.

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