Diabesity: A Lethal Combination

Diabesity: A Lethal Combination

Diabesity is a concept that relates two metabolic pathologies that unfortunately affect a large percentage of the population: diabetes and obesity.

What is Diabesity?

Diabesity is a term that puts under the spotlight two of the biggest problems we face in the field of health: diabetes and obesity.

Obesity is a pathology that for years now has shown no signs of stopping its growth around the world.

This has socioeconomic consequences, and, of course, seriously affects the health of our population.

Obesity is often accompanied by other clinical complications such as type 2 diabetes.

Diabesity problem

This is because both entities share physio-pathological mechanisms.

As a result, some authors have chosen to unite both terms when obesity and type 2 diabetes coexist.

This was where the concept of “diabesity” came from, now well established in the medical community, although the pioneer who coined the term in 2001 was the professor and diabetologist Paul Zimmet.

What are the symptoms

The clinical manifestations of diabesity are attributable to its two components: diabetes and obesity.

In this respect, we come across a problem: diabetes and obesity do not cause pain and are paucisymptomatic (give few symptoms).

Or at least until we reach advanced stages of both diseases, where the complications discussed in the next section occur. In any case, the symptoms would be those of the complications of these pathologies.

Symptoms

And I speak of a problem because if the excess of adipose tissue or diabetes were to generate symptoms, we would act sooner to put a stop to it.

It all starts with an excess of adiposity, which results from a chronic excess of energy due to individual, social, economic, psychological, emotional, commercial, environmental and even political factors.

To say that someone is obese because of “eating too much and not moving enough” is to be extremely reductionist.

This excess fat tissue begins with few repercussions, but as the amount of fat increases, what is known as “lipotoxicity” begins, or damage that the excess fat can exert on other internal organs such as the liver, pancreas, kidneys or heart.

In time, the patient develops a resistance to the insulin hormone in their peripheral tissues, and, finally, an alteration of the hydrocarbon metabolism that justifies the diagnosis of type 2 diabetes.

What risks does Diabesity bring?

There are multiple risks related to diabesity.

For its part, obesity is linked to a whole host of complications, some of them lethal. These include:

  • Cardiovascular disease;
  • Chronic obstructive pulmonary disease (COPD);
  • Arthritis;
  • Some types of cancer; and
  • Other psychosocial problems.

Avoiding processed foods to combat diabesity

Avoiding processed foods to combat diabesity.

Type 2 diabetes is linked to:

  • Hyperglycaemia.
  • Hyperlipaemia.
  • Insulin resistance.
  • Endothelial damage.
  • Low-grade chronic inflammation.

All these circumstances progressively and silently deteriorate the patient’s health, until the irreversible complications of diabetes appear: diabetic nephropathy, diabetic retinopathy or even diabetic polyneuropathy.

And we can’t forget the social repercussions and economic impact on public funds that both conditions entail.

Who suffers form the disease?

It’s clear from the above that everyone overweight or obese is at risk of suffering from “diabesity” (or simply from developing type 2 diabetes).

In fact, up to 85.2% of those with type 2 diabetes are obese or overweight.

Association with diabetes and obesity

In 2025, it is estimated that more than 300 million will have this association with diabetes and obesity.

This is why its impossible to understand both conditions separately (Zimmet et al., 2001).

How do you treat Diabesity?

Treatment for diabesity (type 2 diabetes + obesity) has advanced greatly in recent years.

Nevertheless, and as much as we doctors are committed to developing new drug therapies, lifestyle changes are the most important and first line treatment.

We have hygienic-dietary interventions that are being tested as useful tools in the management of these two conditions.

One of the most well-known and popular interventions is intermittent fasting, which calls for spacing out meals more and introducing periods of fasting into a patients routine. You can find out more about this concept here.

And we can’t forget about low-carb or keto diets, which also play an important role, especially in certain types of patient.

For example, this randomised clinical trial with the ketogenic diet in 34 overweight adults with type 2 diabetes showed a lower A1C (glycaemic control marker) and less need for medication at the end of the study (Boden et al., 2005).

Alongside this, pharmacotherapy has also advanced a lot.

Medication

Today, we have medication that both helps with weight-loss and improves glycaemic control at the same time.

One of the most current trends is the combination of LPG-1 analogues (Liraglutide, Semaglutide, etc.) and sodium/glucose co-transporter 2 inhibitors (iSGLT2) as shock therapy to improve diabesity and its co-morbidities.

Diabesity care

With respect to diabesity care, you could write whole books on the topic, but I’ll outline some of the key points that might be of use to readers:

  • Increasing the amount of protein in the diet will always help in terms of weight loss and maintaining lean body mass.
  • Avoid spending long period of time seated.
Every 90 minutes we spend sat down, we should get up. A good idea is to include periods of “exercise snacks”, such as 15 squats or 5 burpees.
  • Simple sugars should be avoided, as they promote insulin resistance and modify patient consumption behaviour.
  • Working out is an absolute must.
A simple circuit including simple movements (wall press-ups, squats, lunges, tractions) is more than enough to improve both cardio-respiratory fitness and muscle strength and, of course, insulin sensitivity.
  • Circadian hygiene is often overlooked, but it is as important as anything else.
Poor sleep or reversal of rhythms (daytime sleeping) leads to metabolic disorders and poorer control of diabetes and obesity.
  • Adequate management of stress and anxiety are extremely useful skills for these conditions.
Investing in learning to meditate is, for example, one of the best investments you can make to improve your health.

Bibliography

  1. Boden, G., Sargrad, K., Homko, C., Mozzoli, M., & Stein, T. P. (2005). Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Annals of Internal Medicine.
  2. Zimmet, P., Alberti, K. G. M. M., & Shaw, J. (2001). Global and societal implications of the diabetes epidemic. In Nature.

Related Entries

  • In this article we tell you about the importance of preventing obesity from a young age.
  • Can Microbiota be key in tackling obesity? We tell you here.
  • Everything you need to know about the Ketogenic Diet you can find by visiting this link.
Review of Diabesity

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About Borja Bandera
Borja Bandera
Borja Bandera is a young doctor who focuses on nutrition, exercise and metabolism, he combines his professional activity with his vocational dissemination and research.
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