Diabesity

There is no such thing as medical or surgical diseases; only diseases and treatments. Surgery has proven to be the most effective long-term treatment for morbid obesity and the early stages of type 2 diabetes mellitus.

For centuries humanity has witnessed many epidemics that have decimated the population. Nowadays, we are being witnesses of two devastating diseases: Diabetes and Obesity.

Throughout the world, 190 million people have type 2 diabetes mellitus (DM2). It is expected to increase to 324 million by 2025.

In Mexico, DM2 is the first cause of non-obstetric admission in hospitals and the third cause of mortality. The incidence of DM2 increased from 8.8% in 1993 to 11.4% in 1999. This was more evident in southern Mexico where malnutrition is common among native, ethnic groups.

The main reason of the rapid increase of Diabesity is not genetic, but due to poor diet habits (heavy, high-calorie diets) and sedentary lifestyles.

Obesity is a risk factor for the development of DM2 and it is dramatically increasing. From 1993 to 2000, overweight prevalence went from 55% to 62% among Mexican adults. A 27% prevalence in overweight and obesity concerning children and teenagers was also noticed. This weight gain has been associated with decreased physical activity and increased consumption of high-calorie foods and beverages. It has been reported that more than 90% of Mexican children consume soft drinks daily while more than 75% eat snacks and other foods that are high in fats and calories. However, only 3% of the children perform intense physical activity.

Sergio Santoro et al. suggest that there is enough anatomical, physiological, and evolutionary evidence to support the theory that Diabesity is the result of a digestive tract exposed to our modern diet rather than the primitive diet it was designed for.

Our ancestors’ had a low-calorie, high-fiber diet. This type of diet allows that most of the nutrients reach the distal bowel, causing a greater stimulus for the secretion of insulin-regulating hormones such as GLP-1, GLP-2, PYY, and OXM.

Our modern diet is much more concentrated, high in calories, rich in nutrients that are easily absorbed, poor in fibers, and low in residues. Therefore, high concentrations of food and nutrients are absorbed in the small intestine, causing an “empty” distal bowel. This, in turn, causes a decrease in the stimulation of the endocrine L cells that are located in the distal portion of the ileum and the colon. Diabetic and obese patients have a low GLP-1 (the insulin stimulating hormone) secretion.

Nowadays, the gastroenteropancreatic tract is considered as the biggest endocrine organ in the body. The bowel plays a much greater role in regulating appetite, body weight, and metabolism than what scientists had previously imagined.

Today it is recognized that the bowel is an endocrine system highly specialized in neural signals. In fact, recent research shows that intestinal hormones are a key factor in the treatment of major diseases such as obesity and diabetes.

There is also a close link between obesity and DM2. The term “Diabesity” suggests that it is a single disease, which has drastically increased since the mid 80s.

The socioeconomic impact of Diabesity and its complications are dramatic both, for the individual, as well as for his family and society. This is particularly important due to the progressiveness of the disease, since Diabesity causes deterioration of multiple organs and systems. Not only is DM2 the most common cause of adult blindness, limb amputation, and kidney failure, but also a significant risk factor for coronary artery disease.

The highest priority of national health systems should be to focus on changing lifestyles and diet habits of individuals in order to prevent this Diabesity epidemic.

It is well documented that a substantial weight loss through diet and exercise is associated with a better control and fewer complications of Diabesity. Moreover, it reduces the mortality rate thereof.

Theoretically, the ideal treatment for Diabesity should be aimed at achieving a sustained reduction in weight and long-term glycemic control. Unfortunately, current therapies such as diet, exercise, behavioral therapies, oral hypoglycemic agents, and insulin rarely keep a patient in a real euglycemic state. In addition, some hypoglycemic drugs cause weight gain (with the exception of metformin and acarbose).

Obesity and diabetes have drastically increased over the last years due to a decrease in primary prevention. The end results are devastating. If you suffer from Diabesity, do not wait any longer! Contact us, and begin your new life today!