What is Diabesity?
Diabesity is a comprehensive term that represents the most challenging health care epidemic ever seen by Americans and affects more than 1.7 billion people globally. The word Diabesity was created to represent the exploding epidemics of obesity and type 2 diabetes. I love the term Diabesity because from a conceptual standpoint, it targets the underlying cause of type 2 diabetes well before the individual is formally diagnosed. Diabesity encompasses the continuum of progressive insulin resistance from optimal metabolism and blood sugar control to full-blown type 2 diabetes.
Current medical guidelines are not working
By our current medical standard of care, you are not considered “diabetic” until your fasted glucose reaches 126 or above. Not to mention that the average delay in diagnosing type 2 diabetes by this standard ranges from 4 – 10 years! By the time you are diagnosed, you have already burned out 50 – 80% of the beta cells in your pancreas that secrete insulin, and most likely have other complications associated with the disease. The current diagnostic criteria for diagnosing diabetes is arbitrary at best and completely misses the fact that type 2 diabetes is driven by environmental and lifestyle choices that lead to insulin resistance and belly fat. Think about it. Do you really think having a fasted blood sugar of 120 is any different than 126? It gives you the “false allusion” that you are “safe” since you do not actually have type 2 diabetes by the current diagnostic criteria.
First of all, it is typically the post meal blood sugar that rises first, not the fasted glucose. The disadvantage of using the fasted glucose as our primary marker for type 2 diabetes is that it tests your system at rest when in reality, we need to see how your body responds to a glucose or carbohydrate load. And it is not just about how much your blood sugar goes up after you eat, it is also about your insulin response. But here is my question –Why are we waiting for blood sugar to rise before we intervene? Why are we waiting for a significant beta cell loss and allowing the consequences of insulin resistance to run amuck before we “diagnose” someone? Looking at the continuum of Diabesity, it is very clear that insulin resistance and belly fat alone have severe metabolic and cardiovascular consequences.
Diabesity in America
- Two thirds of adults are overweight or obese.
- Type 2 diabetes has tripled in the past 30 years.
- Nearly 27 million adults have been diagnosed with type 2 diabetes, many more are undiagnosed.
- An estimated 70 million with pre-diabetes, most are undiagnosed
- My average patient with type 2 diabetes is on at least 8 pharmaceutical medications.
- Even more startling is the exploding rate of obesity of type 2 diabetes in children & adolescents.
- Diabesity has been associated with a 3 – 4 fold increase in heart disease, stroke, dementia and an increased risk of liver disease, autoimmune disease and even cancer.
- Type 2 diabetes is the leading cause of blindness (ages 20 – 74), kidney disease and nerve damage and an increased risk for limb amputation, depression, infection, periodontal disease and many other chronic conditions.
And this is just the tip of the iceberg……
Diabesity is a “food born” illness – Dr. Mark Hyman, MD
Now the good news –Diabesity is preventable and almost always reversible.
The unabated rise in obesity and type 2 diabetes sends a clear message that our current model for diagnosing and treating diabetes is not working. We need to change the way that we look at this problem and more aggressively target the underlying issues that are fueling insulin resistance – lifestyle, the American diet and other environmental factors. Over the next four weeks I will be reviewing underlying physiology and consequences of Diabesity, but more importantly re-framing Diabesity into a new model of medical practice that focuses on treating the underlying triggers for this disease through lifestyle and environmental modification. While I will discuss some of the unique issues related to diabetes and women, most of the information I will present this month applies to anyone. Please share this valuable information with your family, friends and co-workers – we can fight this epidemic together.