Medicus, Vol. 27 No. 1 Debljina i ..., 2018.
Review article
Diabetes and Obesity – a Vicious Circle
Sanja Klobučar Majanović
Abstract
Over the last few decades, we have witnessed a dramatic increase in the number of diabetic patients worldwide. This pandemia is primarily due to increasing prevalence of type 2 diabetes. The fact that over 80% of the patients are overweight or obese indicates a strong association between the obesity and the risk of developing type 2 diabetes. These epidemiological indicators are mostly affected by the modern lifestyle characterized by over-consumption of refined, highly processed foods, rich in saturated fats and simple carbohydrates together with a low level of physical activity. In addition to total body fat, the distribution of adipose tissue between visceral and subcutaneous compartments is an important determinant of the risk of developing diabetes. It has been found that changes in visceral adipose tissue and immune response disregulation play a key role in initiating and maintaining a vicious cycle of insulin resistance, chronic systemic inflammation and endothelial dysfunction as the underlying pathophysiological mechanisms of type 2 diabetes, as well as other manifestations of metabolic syndrome such as dyslipidemia, arterial hypertension, non-alcoholic fatty liver disease, and ultimately cardiovascular disease. Effective weight management is crucial in preventing the onset and progression of type 2 diabetes and associated cardiovascular risk factors. Lifestyle interventions aimed at improving dietary habits and increasing physical activity is a cornerstone of diabetes management. When prescribing antidiabetic medication therapy, preference should be given to those drugs that have a beneficial effect on body weight. Metabolic surgery has become a promising new option for the treatment of obese patients with type 2 diabetes.
Keywords
adipokines; diabetes type 2; metabolic syndrome; obesity; visceral adipose tissue
Hrčak ID:
199416
URI
Publication date:
26.4.2018.
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