Defining diabesity: an in-depth analysis of the etiologies and treatments associated with obesity induced type 2 diabetes
Choudhry, Saad Jawed
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The future implications of escalating obesity and diabetes in the global population impose negative repercussions on developing countries. It is projected that newly identified cases of diabetes will reach unprecedented levels, i.e. hundreds of millions in the next two decades (Prentice, 2005). The uphill trends in the prevalence of obesity parallel the uphill trends in the prevalence of type 2 diabetes. This phenomenon is designated diabesity (Caprio, 2003). Unraveling the multiple factors that serve as possible targets for the treatment of diabetes is an immense challenge to health care providers today (Ramlo-Halsted and Edelman, 2000). It is important to note that diet, exercise, and medications continue to be the cornerstones of diabetes therapy. However, adequate glycemic control remains difficult for many patients taking hypoglycemic medications (Cummings, 2011). In addition, it is debated whether a lifestyle modification intervention is practical, as individuals fail to adhere to the lifestyle modifications prescribed during the intervention trial, devoid of intensive follow-up. This brings up the intriguing question of whether or not the results of such lifestyle modification intervention trials can be translated to the general population (Tuomilehto et al., 2011). However, novel initiatives present novel opportunities for the prevention and/or treatment of diabetes (Cummings, 2011). "We are in the process of redefining one of the most common diseases in America as an autoimmune disease, rather than a purely metabolic disease; this work will change the way people think about obesity, and will likely impact medicine for years to come as physicians begin to switch their focus to immune-modulating treatments for Type 2 diabetes," Daniel Winer, an endocrine pathologist at the University of Toronto, said in a statement (Maugh II, 2011). Mounting evidence indicates the involvement of immune dysfunction as a primary determinant in the development of insulin resistance and type 2 diabetes. Thus, immune modulation may be a functional tool in treating the disease (Zhao et al., 2011).
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