The Diabesity Epidemic

“Diabesity” is diabetes caused by overweight or obesity and the “Diabesity Epidemic” refers to the rapid parallel increase in prevalence of the two conditions over the last few decades.

The prevalence of diabetes has reached epidemic proportions. The International Diabetes Federation estimates that 380 million people worldwide have diabetes and it is estimated to increase by 55 percent to close to 600 million by 2035. In our country, the prevalence of diabetes mellitus (based on FBS) has increased from 3.4 percent in 2003, to 4.8 percent in 2008, to 5.1 percent in 2013—or approximately 5 million people diagnosed with diabetes. It is estimated that about an equal number have the disease but do not know it.

The increase in the prevalence of diabetes is paralleled by a marked increase in the prevalence of obesity. Obesity may be diagnosed by determining one’s body mass Index or BMI. BMI is the ratio of your weight in kilogram divided by height in meters squared. According to the Asia-Pacific Obesity guidelines, normal weight is BMI 18.5-22.9 kg/m2, overweight is BMI 23-24.9 kg/m2 and obese is BMI>25 kg/m2.

Another important measure of obesity is visceral or abdominal adiposity. This refers to fat accumulation in the abdomen, or what is referred to as “beer belly” or “spare tire” syndrome. A simple way to measure visceral adiposity is to measure your waistline. A healthy waistline would be less than 31 inches in females and less than 35 inches in males.

Diabesity has also been defined as a metabolic abnormality that can range from mild blood sugar imbalance (prediabetes) to full-blown type 2 diabetes, accompanied by the following signs: abdominal or visceral obesity, abnormal lipids (low HDL, high triglycerides, normal to mildly high LDL), high blood pressure and high fasting blood sugar.

Are you at risk to develop diabetes? Ask yourself whether you have any of the following risk factors: family history of diabetes, being overweight or obese, eating an unhealthy diet, physical inactivity, increasing age, high blood pressure or history of diabetes during pregnancy. If you answered yes to any of these factors, then you are at risk.

What can you do to minimize the risks of developing diabesity? Get smart about what you eat. Eliminate processed carbohydrates, sugars and saturated fats from your diet. Eat more lean protein (fish or chicken), vegetables, beans, whole grains (like brown/red rice, whole wheat bread/pasta). Walk more! Aside from changing your diet, exercise is probably the single best preventive measure for diabesity. Walk for at least 30 minutes every day. If you want to lose weight, do more vigorous exercises like aerobics, dancing, biking, swimming for 45-60 minutes at least 5 days a week.

If you are overweight or obese, you need to lose weight. Weight loss has many beneficial effects including improved function of the beta cells of the pancreas, which produce insulin, improvement of other risk factors for heart disease, like blood pressure and elevated lipids (cholesterol).

Consult your doctor. The best way to contain the “Diabesity Epidemic” is to screen for early detection, prevention and management of obesity in younger individuals, before they develop diabetes. Your doctor will perform a routine physical examination and some simple blood tests that will identify your risk of developing diabetes. He/she can also advise you about proper nutrition, exercise and behavioral interventions that can produce sustained weight loss. He/she may also put you on medications to stop the progression to diabetes if you are already at high risk.

Like most diseases, the earlier Diabesity is picked up, the more we can do about it. Early detection is very important. Remember that the complications of diabetes are preventable.

Dr. Cynthia Halili-Manabat is an endocrinologist and past president of the Philippine Society of Endocrinology, Diabetes and Metabolism. The A to Z of Health Information Advocacy is a joint initiative of a group of medical specialists and supported by AstraZeneca Philippines aimed at raising public awareness on various diseases and providing health information and updates to the healthcare community.