Type II diabetes: obesity and overweight
Diabetes has become a widespread epidemic, primarily because of the increasing prevalence and incidence of type 2 diabetes. Diabetes is an endocrine disease in which the body has either a shortage of insulin or a decrease ability to use insulin or both. Insulin is a hormone that allows glucose to enter the cells and be converted into energy. Diabetes can be characterized as a prevailing, incapacitating, and deadly disease. There are a number of risk factors that increase a person’s tendency toward developing type II diabetes. Modifiable risk factors include obesity, physical inactivity and poor dietary habits are just a few. The incidence in overweight and obesity is responsible for the increase in the prevalence and management of type II diabetes, but a lifestyle adjustment aimed at reducing or monitoring weight and increasing physical activity is the resolution for overweight and obese patients with type II diabetes. First, weight management in the prevention and management of type II diabetes through lifestyle modification are essential because being overweight or obese can lead to multiple complicated health issues. “The prevalence of type II diabetes in obese adults is 3–7 times that in normal-weight adults, and those with a BMI > 35 are 20 times as likely to develop diabetes as are those with a BMI between 18.5 and 24.9. In addition, weight gain during adulthood is directly correlated with an increased risk of type II diabetes” (Klein & Sheard, 2004, p. 260). Obesity complicates the management of type II diabetes by increasing insulin resistance and blood glucose concentrations.
Patients with diabetes are at high risk for developing cardio-vascular disease. Stroke and ischemic heart disease have the greatest morbidity from diabetes (Klein & Sheard, 2004). Elevated glucose levels help contribute to atherosclerosis and increase the likelihood of macro cardiovascular. Peripheral arterial disease (PAD) is another complication of diabetes that occurs because of narrowing of the blood vessels. PAD manifests itself by presenting with intermittent pain, aches, or discomfort when walking or exercising, but disappears with rest (Deshpande, Harris-Hayes, & Schootman, 2008). Over time, sustained exposure to increased blood glucose levels in the body causes proteinuria, hypertension, and renal failure. The regulation of blood flow through the kidney is lost, causing excessive perfusion and filtration, which results in micro-albuminuria (Deshpande et al., 2008, p. 1260).
Managing diabetes can be challenging. The major goal of treatment plan is to reduce elevation of blood glucose levels to avoid all these potentially life threatening diseases. Secondly, increased physical activity can prevent or delay the development of type 2 diabetes especially in high-risk individuals, such as those with impaired glucose tolerance. Although regular physical activity may prevent or delay diabetes and its complication, most people with type 2 diabetes are not active (Coldberg, 2010). “Overweight and physical inactivity account for more than 300,000 premature deaths each year in the U.S., second only to tobacco-related deaths. Obesity is an epidemic and should be taken as seriously as any infectious disease epidemic, “says Jeffrey P. Koplan, director of the CDC, and one of the authors of the JAMA article. “Obesity and overweight are linked to the nation’s number one killer–heart disease– as well as diabetes and other chronic conditions.”(Must, Spadano, & Coakley, 1999, p. 1525). Type 2 diabetes is also increasing in prevalence in children and adolescents, with increasingly sedentary behavior and obesity as key contributors.
There are less opportunities in daily life to burn calories: children watch more television daily; many schools have done away with or cut back on physical education; many neighborhoods have a shortage of sidewalks for safe walking; the workplace has become increasingly robotic; household chores are assisted by labor-saving machinery; and walking and cycling have been substituted by automobile travel for all but the shortest distances (Klein & Sheard, 2004). The American lifestyle of convenience and inactivity has had a damaging toll on every fragment of society, particularly on children. One solution that is recommended is weight loss by special dietary guidance and setting a goal that is both reachable and sustainable. The vast majority of overweight people at risk of type 2 diabetes can prevent symptoms by losing a few percent of their body weight. Moderate weight loss can improve insulin action, decrease fasting blood glucose concentrations, and reduce the need for diabetes medication. Weight loss has important additional health benefits in patients with diabetes because it improves other risk factors for cardiovascular disease by decreasing blood pressure, improving serum lipid concentrations (decreases in serum triglycerides, total cholesterol, and LDL-cholesterol concentrations and increases in serum HDL-cholesterol concentrations)(Klein & Sheard, 2004). Weight loss is recommended for all overweight or obese adults who have type 2 diabetes or who are at risk of this disease.
It is important to set a weight-loss goal that is both achievable and maintainable. A variety of diets have been suggested to treat obesity. Although many different dietary approaches may result in short-term weight loss, the limitations of most diets are poor long-term compliance and weight regain. Recently, studies have shown that a low-fat diet is considered to be the guide for conventional therapy for treating obesity (Klein & Sheard, 2004). It is unlikely that one diet is ideal for all overweight and obese persons therefore dietary guidance should be adjusted to each individual to allow for specific food preferences and individual methods to reducing energy intake. Type 2 diabetes is affecting the younger population like never before, about 1 in 400 children and adolescents are diagnosed. To manage and prevent Type 2 diabetes the family should have a healthy and active lifestyle which will create a good base of preventative measures towards overweight and obesity. These measures should also include extended family members as well as care providers due to their influence on children. Enforcing healthy habits tends to be much easier than to lose weight due to parents feeling guilty of depriving their children of food when they are on a strict diet. Create a relaxed atmosphere around mealtime. Eat slowly and enjoy your food. Eat together as a family, and don’t watch TV during meals.
Families that do not eat together tend to consume more fried foods and soda, and less fruits and veggies than families that share meals. Be a positive role model, remember the old adage: “Kids will do as you do, not as you say”? Your kids look to you, the parents, to see how to behave. If your whole family eats healthy foods and gets active, and then your child will, too! Set short-term goals for changes in your child’s diet and exercise on a weekly basis. Update your goals each week. Write them down. Examples of goals include setting a time limit on, T.V. watching and taking a walk every day. Make sure the goals you set are realistic. For example, exercising an hour every day is unrealistic for a child who is de-conditioned, and not used to even minimal physical activity. Use rewards when your child meets their weekly goals. Rewards could be special time with you doing an activity your child enjoys or a special toy. Have your child keep a record of their food intake and exercise. This will allow them to be more self-aware of their behavior. Then look at the record together, one-on-one, and go over it. Give them positive feedback. Praise your child for healthy food choices and physical activity. Remember: criticism and punishment just don’t work. Make sure your child understands that they can make a difference in their weight and that you will support them all the way
Another, solution is to partake in regular physical activity; it may prevent or delay type 2 diabetes and its complications. Exercise is very important for patients diagnosed with diabetes to exercise regularly to reduce weight. This is critical treatment for diabetes because exercise increases the body’s sensitivity to insulin, resulting in better control of blood glucose elevation (Deshpande et al., 2008, p. 1155). Patients with type 2 diabetes should be encouraged to maintain or regain an acceptable body mass index. Aerobic exercise has been the approach traditionally prescribed for diabetes prevention and management. Even 1 week of aerobic training can improve whole-body insulin sensitivity in individuals with type 2 diabetes (Klein & Sheard, 2004). In previously inactive patients, preliminary exercise program should be of short duration and then gradually increase to 30 min of low-intensity activity.
The intensity can be increased as the patient’s strength and fitness improve. In developing a physical activity program, the doctor should devise a plan that can be sustained without injury on the basis of the patient’s current level of activity and willingness to increase activity (Klein & Sheard, 2004). Increasing daily physical activity, such as walking and climbing stairs, is also effective. Regular physical activity may prevent or delay diabetes and its complications if it is done with obedience. In the United States, type 2 diabetes is one of the primary causes of cases of blindness, end-stage renal disease, and foot and leg amputations. If this present-day trend continues one out of three American’s will have diabetes by 2050. With appropriate lifestyle modifications, type 2 diabetes can be prevented. Moderate weight loss and increased physical activity can prevent or delay the development of type 2 diabetes. Managing diabetes can be challenging but if we as a nation adhere to the lifestyle changes there would be a healthier America.