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Breaking the vicious cycle

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Health If you are obese and Indian, chances are you may turn diabetic, say experts to Hema Vijay

WORRYING TIMEControlling weight is fundamental for managing type two diabetes
WORRYING TIMEControlling weight is fundamental for managing type two diabetes

“If you randomly examine 100 lean people, it is possible that five of them may have type two diabetes that accounts for 95 per cent of all diabetes occurrences.

On the other hand, if you randomly examine 100 obese individuals, 30 to 40 of them would have diabetes.

If you consider 100 diabetic individuals, nearly 60 of them would be overweight or obese”, says Dr. V. Mohan, chairman, Dr Mohan’s Diabetes Specialties Centre. Diabetes and obesity often go hand in hand and keeping diabetes in check calls for keeping obesity at bay.

The presence of excess fat in the body increases the body’s resistance to insulin (the hormone that keeps blood sugar level in check). So the more obese a diabetic is, the more medication he or she has to take to counter the condition. Increase of medication could also lead to increase in body weight. And so it becomes a vicious cycle.

Decreasing body weight lowers the body’s insulin resistance, allowing a relatively lower diabetic medication to work better. This is why controlling weight is so fundamental to the management of type two diabetes.

Who is obese?

Body weight alone is not an indicator of obesity. Body mass index (BMI) is the criteria. BMI is the measure of a person’s body weight (in kilos) divided by the square of his height (in metres). A BMI of 23 is normal; 23-25 indicates overweight; and anything over 25 indicates obesity. A BMI of 25-30 indicates mild obesity, 30-35 means a person is moderately obese; and a BMI above 35 reflects severe obesity.

Indians are genetically prone to diabetes that can occur in them even at a lower BMI.

“A waist measure of 90cm or more for males and 80cm or more for females indicates abdominal obesity, which is an even more important risk indicator of type two diabetes”, says Dr. Arul Kumar, consultant diabetologist.

Reversing obesity

Obesity could be the fall out of many things, such as binge-eating, a faulty diet or physical inactivity.

Institutions such as Dr. Mohan’s have obesity and weight management centres. “We need to treat both the cause and complications of obesity”, says Dr. Mohan.

Losing weight is a challenge and maintaining the weight loss is even tougher. While we are well aware that brown rice has a lower glycaemic index than white rice, do we know that a single idly contributes 65 calories and a dosa can add up to 120 calories?

“Just eating one small extra dosa a day that we are unable to burn might end up as a weight gain four or five kilos over a year. Every calorie counts”, warns Dr. Y.D.M. Prasad, obesity and weight management physician, diabetologist and endocrinologist.

“But a loss of even five to ten per cent of one’s body weight reduces the risk of diabetes by more than 50 per cent”, says Dr. Mohan. And the bonus is that weight loss also lowers the risk of blood pressure, osteoarthritis, and heart disease.

Fat check

• Burning 100 calories requires six minutes of running, 30 minutes of walking or two hours of dishwashing!

• Obese diabetics may need an increased dosage of medication, that in turn could lead to further weight gain

• Lowering weight lowers the body’s insulin resistance, and allows a relatively lower dosage of diabetic medication work more efficiently

• A BMI of over 25 indicates obesity and a predisposition to type two diabetes.

• Indians are prone to diabetes at lower BMIs

• Diabetes can be tackled with a combination of exercise and a diet of low glycaemic index foods.

• Even losing five to 10 per cent of one’s weight reduces the risk of diabetes by more than half

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