Dynamics of diabetes and obesity: Epidemiological perspective

Abstract

The purpose of this review article is to understand the current literature on obesity, diabetes and therapeutic avenues across the world. Diabetes is a chronic lifestyle condition that affects millions of people worldwide and it is a major health concern in our society. Diabetes and obesity are associated with various conditions, including non-modifiable and modifiable risk factors. Early detectable markers are not well established to detect pre-diabetes and as a result, it becomes diabetes. Several published epidemiological studies were assessed and the findings were summarized. Resources from published studies were used to identify criteria used for pre-diabetes, the role of diet in pre-diabetics and potential risks and characteristics associated with pre-diabetes. Preventive strategies are needed to combat diabetes. Individuals diagnosed with pre-diabetes need detailed education, need to fully understand the risk factors and have the ability to manage diabetes. Interventions exist that include chronic disease self-management programs, lifestyle interventions and pharmacological strategies. Obesity plays a large role in causing pre-diabetes and diabetes. Critical analysis of existing epidemiological research data suggests that additional research is needed to determine the efficacy of interventions. This article is part of a Special Issue entitled: Oxidative Stress and Mitochondrial Quality in Diabetes/Obesity and Critical Illness Spectrum of Diseases - edited by P. Hemachandra Reddy.

Keywords: Alzheimer's disease; Diabetes; FTO; Obesity.

Figure 1

Major disease conditions and incidents for mortality in the US. Either diabetes mellitus or Alzheimer’s disease is 5^th or 6^th leading cause of death in these states. Mortality rate represented per 1000 population. (Data adopted from all the states departmental health websites as on January, 2016).

Figure 1

Major disease conditions and incidents for mortality in the US. Either diabetes mellitus or Alzheimer’s disease is 5^th or 6^th leading cause of death in these states. Mortality rate represented per 1000 population. (Data adopted from all the states departmental health websites as on January, 2016).

Figure 2

T1DM (insulin deficiency), T2DM (insulin resistance) causes cognitive impairments, phosphorylation of tau, amyloid beta production, GSK3β activation, Wnt/catenin activation, low ATP production, increased free radicals, defective mitochondrial function. All these symptoms are similar to the Alzheimer’s dementia and can be termed as ‘type 3 diabetes’.

Figure 3

Overview of plasma glucose concentration regulation in the body. Hyperglycemic and hypoglycemic hormones play crucial role on the regulation plasma glucose concentration.

Figure 4

Deciphering pre-diabetes factors such as age, BMI, family history and family back ground of different ethnic population

Figure 5

Schematic approach in pre-diabetes clinical screening and interventions. The suggested interventions are increase in physical activity, stop smoking, diet (antioxidant, low carbo hydrate, low SFA: High PUFA) and management for stress.