Diabetes

14 November 2017

Obese people are 80 times more likely to develop this disease

Obese people more likely to develop type 2 diabetes than those with a normal body-mass index.

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One in 11 adults worldwide is living with diabetes, according to the International Diabetes Federation (IDF) which released the new estimates in its Diabetes Atlas today (14 Nov).

Two-thirds of Africans with diabetes have no idea that they are living with the condition, which causes complications affecting the eyes, heart, kidneys, nerves and feet.

Biggest killer of SA women

In South Africa, 10 000 new diabetes cases are being recorded every month by public health clinics, according to the health department.

Diabetes became the biggest killer of South African women in 2015 and the second biggest killer after tuberculosis, according to StatsSA. This is perhaps not surprising when 70% of women and 40% of men are overweight.

“I have a very long waiting list of patients to see me, and 90% is diabetes-related. And few endocrinologists are not fully booked,” says KwaZulu-Natal-based Dr Aslam Amod, who gets around 30 new diabetic patients every day.

For Amod, the only really successful diabetes treatment is prevention. “Everything else is just dealing with the fallout.

“There is enough evidence to say obesity is the starting point for 80% of type 2 diabetes,” he explains. “Obesity sits at the centre and hypertension, dyslipidaemia, heart disease and other linked chronic conditions, radiate out from this pivotal point.”

Obese people are up to 80 times more likely to develop type 2 diabetes than those with a normal body-mass index. This is in part because fat cells make the body less sensitive to insulin, which then disrupts the body’s processing of sugar.

A leap in obesity

Amod says that even with specialist care, up to 40% of people with diabetes will still experience the high-cost and devastating complications: “The sadness we face as doctors is that we treat patients for years but many don’t make the lifestyle changes we advise. The penny only drops when they face a serious complication,” he adds.

Dr Craig Nossel, head of Discovery Vitality Wellness, blames the leap in obesity on “a combination of our human nature our own fundamental limits of self-control and the unconscious way we are hard-wired to eat – with the modern food jungle environment of large portion sizes, low prices of unhealthy foods and the nature of food advertising”.

Two million South Africans are Vitality members, and those that are highly active have a 53% lower instance of diabetes than inactive members, says Nossel.

Despite the surge in diabetes cases, government’s response has been sluggish – with costly consequences.

“The cost of treating diagnosed diabetics is approximately R3.6-billion for this year alone, according to research we have just completed and not yet published,” says Professor Karen Hofman, Director of Priceless SA, a health economic policy research unit at Wits University.

Dr Nam Cho, the incoming president of IDF, says that “diabetes causes devastating personal suffering and drives families into poverty”.

Numbers expected to spiral

The focus of this year’s Diabetes Day is on women, as over 200 million women are currently living with diabetes.

“Women with diabetes are more likely to be poor and have less resources, face discrimination and have to survive in hostile social environments,” according to IDF.

Katie Dain, CEO of the Non Communicable Diseases Alliance (NCD Alliance), says that "within 30 years, the numbers of people living with diabetes is expected to spiral to almost 700 million people, and global health expenditure will exceed $776 billion.

“This represents nothing less than a global health tsunami that is undermining the health and productivity of populations and crippling economies.”

In order to address the crisis of NCDs including diabetes, the United Nation has called a special High-level Meeting next year. – Health-e News.

Image credit: iStock

 

Ask the Expert

Diabetes expert

Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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