Insulin Resistance, Obesity and Diabetes: Metabolic Syndrome
Type II or Adult-Onset diabetes is a disease of elevated blood sugar related to insulin resistance. Over 85% of people diagnosed with type II diabetes are overweight and drastic weight control through bariatric surgery has been shown to virtually cure the illness in many patients. The mechanisms by which obesity influences type II diabetes are complex, but even modest weight loss through simple exercise or dietary modification often causes significant improvement of the disease. Nevertheless, type II diabetes is a complex illness and not all type II diabetics are overweight and by no means do all overweight people develop diabetes.
There are a number of important risk factors for type II diabetes including family history, low HDL cholesterol level, hypertension, ethnicity that is African American, Native American and hispanic American; but more significant than any of these is obesity. This makes weight loss among the most important medical goals for type II diabetic people.
With weight loss, type II diabetes usually improves so that insulin dependent people can often lower or even eliminate their need for injections and patients taking oral medication likewise can take less and even sometimes no medications.
We treat many diabetic patients in our practice. Not only are they elligible for medical weight control therapy, they are among the best candidates since they stand to gain such a dramatic improvement in health with weight loss. Generally Dr. Holland wants diabetic patients to be under the care of a primary physician for their diabetes and wants to see that a patient's blood sugar levels are being adequately controlled by medication before starting them on weight control medications. He asks that his diabetic patients monitor their blood sugar level at home, usually daily, while losing weight.
Special Note About Metformin and Byetta
Metformin is an oral medication used to help control blood sugar in type II diabetics and it can often have the side effect of producing some weight loss. Byetta, which is discussed in more detail on another page of this website, is a very unusual injectible drug used in the treatment of type II diabetes, approved by the FDA in 2005, that lowers blood sugar and sometimes produces remarkable weight loss. Dr. Holland encourages his diabetic patients to discuss these medications with their primary care physicians if they are not already taking them.
Conclusion: Obesity Causes Insulin Resistance and Insulin Resistance Causes Obesity and Type-2 Diabetes
Obesity is a major, if not THE major risk factor for type II diabetes and the treatment of obesity is therefore a critical goal in the management of that disease. Medical weight control, including the use of appetite medication can often be undertaken in people with diabetes provided that their health and blood sugar levels are good.