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Bobby Brown
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Your Waistline and Diabetes

Published on 7/9/2018
For additional information  Click Here

If your waist is expanding, so are your chances of coming down with diabetes, even if you think you're too young to get sick. Researchers have found that extreme obesity raises the risk of the disease to levels usually faced only by older people.

"It appears that the timing of when you develop diabetes is determined by how overweight you are," says Dr. Teresa Hillier, an endocrinologist and a member of the Kaiser Permanente Center for Health Research team that studied the connection.

But there's hope for fat people worried about their health. "Even a loss of just 10-15 pounds can make a big difference in their risk for developing diabetes or improving the diabetes that they've developed," Hillier says.

Type II diabetes, in which the body either doesn't make enough insulin to regulate blood sugar or can't properly handle the insulin it does make, generally has been considered a disease of senior citizens, especially people over 50. But rates of Type II, which makes up 95 percent of all diabetes cases, skyrocketed in the 1990s among young people, even teen-agers. Experts estimate the rates went up 70 percent among people aged 30-39. Type II diabetes usually can be controlled with diet and exercise, but sufferers also may need drugs.

The Kaiser Permanente team reviewed the medical records of 2,437 adults diagnosed with Type II diabetes between 1996 and 1998 in Oregon and southwest Washington.

The study, funded by the American Diabetes Association, appears in the September issue of Diabetes Care.

People aged 18-44 who were newly diagnosed with Type II diabetes had an average body mass index (BMI) of 39. The index measures a person's weight-to-height ratio. An index of 26-29 is considered overweight; higher numbers are considered extreme obesity.

For instance, a 5-foot-9 person with a BMI of 39 would weigh 263 pounds and be considered "very obese," about 100 pounds overweight.

The study found people who developed diabetes after age 45 generally were a bit thinner, but still very overweight. Their average BMI was 33, the equivalent of a 5-foot-9 person weighing 222 pounds.

"Obesity clearly sticks out as a striking difference" between the people who developed diabetes and others, Hillier says. For each 1-point increase in BMI -- 5 to 8 pounds -- the risk of developing diabetes rose 6 percent, she says.

Many patients with Type II diabetes also were at high risk for heart disease. More than 80 percent had high cholesterol, and nearly half had high blood pressure.

"These people getting diabetes at a young age are also going to get heart disease several decades earlier," Hillier says.

The study is worthwhile because it statistical pinpoints how weight contributes to diabetes, says Dr. Larry Wu, a family physician in Durham, N.C. "Clinicians have known for decades, if not centuries, about how [more] body weight increases the chances of diabetes," he says.

Obesity seems to cause diabetes in two ways, Wu says. First, obese people usually aren't active, which means that glucose, or blood sugar, remains in the bloodstream instead of going to muscles where it's needed during exercise. "It's like having gasoline in the pipeline, but there's no car to use it. In this case, it does damage to multiple areas, including the eyes, the kidneys, the blood vessels and the nerves," Wu says.

Second, people with lots of fat tissue become more resistant to insulin, which pushes glucose out of the blood stream, he says. The pancreas, which produces insulin, becomes overwhelmed by having to do extra work.

Hillier says dropping pounds is key to keeping diabetes at bay, especially in light of a recent study that found modest weight loss and modest exercise -- 30 minutes of walking a day -- can dramatically reduce the risk of Type II diabetes.

"We really need to be thinking as individuals and a society about how we're going to encourage people to lose modest weight," she says.

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