The World Health Organization recently classified Type 2 diabetes as an international epidemic, which will appear in 300 million patients in the next few years. The frequency of the disease, along with a rise in obesity, has increased by 50 percent in the last decade, spreading through the industrialized world. Many researchers have found that obesity, especially in the stomach area – unlike in the thighs – was a direct cause of diabetes. If we'll look at obesity as a key factor of the disease, we'll be able to perceive it in a new light and treat it from another angle.
Diabetes is caused by the combination of damage to the pancreas, which produces the insulin hormone, and the decrease of the tissues’ sensitivity to this hormone. Insulin is responsible for moving sugar from the blood to the body's cells. Its absence results in an increase in the sugar level in the blood.
The disease is characterized by an acceleration of the disease's processes and atherosclerosis, and damages all body organs.
As the disease progresses, it can cause other dangerous conditions – damaging the eye to the point of blindness, damaging the kidneys to the need for dialysis, damaging circulation to the feet to the need for amputation and drastically impacting nerve function. Most significantly, diabetics are at severe risk of damage to the heart and brain resulting in heart attacks and strokes – all of which decrease life expectancy.
Until recently, patients who suffered from diabetes and obesity were treated with medications that caused additional weight gain – an average gain of five percent of the initial body weight. This weight gain, much like diabetes, also damages the body’s organs. In addition of being a risk factor for diabetes and heart disease, it can cause many other diseases, such as gout, gallbladder diseases, fatty liver, damage to the arteries and back, respiratory arrest and cancerous tumors.
The ideal diabetes medication decreases the sugar level in the blood, causes weight lose, protects the pancreas from further damage and reduces other risk factors such as elevated cholesterol and blood pressure.
This medication already exists – weight loss and physical exercise are the “magic pill.” Extensive research has proven that the most effective way to protect the pancreas and prevent complications, is a combination of moderate exercise – such as a daily half-hour of intense walking – and a moderate diet that reduces the initial body weight by five-to-ten percent. However, patients often find it difficult to maintain this regime and this “magic pill” loses its effect.
Recently new medications have been approved that result in weight loss, reduced blood sugar level and a decrease of other risk factors such as high cholesterol and blood pressure.
Bariatric Surgery is among the most effective treatment for weight loss today. There are two common bariatric surgical procedures – gastric banding, in which a device is implanted in the stomach to reduce its size, and bypass gastric surgery, in which the small intestine is re-routed to a small stomach pouch. Research has shown that these surgeries lead to a weight loss of 50 percent or more. As in any surgery, there is a small risk of complications during and after the surgery. Over 75 percent of people with diabetes who undergo this operation no longer require medication, and actually "heal." Those who still need medication usually experience significant improvement in their disease after the surgery.
In the years to come, an ever increasing understanding of diabetes, along with new medications will provide a better treatment – not just for their blood sugar levels, but also for the ensuing metabolic disorders – blood pressure, obesity and other complications.
This Health Tip courtesy of Dr. Roy Eldor, Diabetes Unit, Department of Medicine.