Dr Barbara McGowan
Professor of Endocrinology and Diabetes, Guys and St Thomas’s Hospital, London
Obesity is a chronic disease and a major risk factor for prediabetes and Type 2 Diabetes (T2DM).
Over 463 million people worldwide have T2DM and may experience complications including cardiovascular diseases, erectile dysfunction, amputations, kidney failure and blindness. Prediabetes is not a benign state and raises cardiovascular risks. Early intervention in diabetes management is crucial to prevent its potentially devastating complications.
Why obesity and T2DM lead to insulin resistance
Insulin resistance, linked to obesity and T2DM, occurs when visceral abdominal fat accumulates around the liver and pancreas, causing insulin to become less effective. The good news is that weight loss can reduce visceral fat, reverse insulin resistance and improve blood sugar levels, potentially leading to T2DM remission.
Early weight loss interventions for individuals with prediabetes and T2DM can reverse the disease and prevent long-term complications.
Losing weight for T2DM remission
The DIRECT study showed that 15 kg weight loss within the first year, achieved through a total diet replacement program followed by structured weight maintenance, resulted in T2DM remission in over 80% of patients. Alternative approaches include intermittent fasting, time-restricted eating and physical activity.
Digital solutions to support patients’ weight loss journey are now available. When diet, exercise and behavioural interventions alone are insufficient, pharmacotherapy options like GLP-1 agonist injections or bariatric surgery may be recommended for individuals with a BMI over 35 and early-onset T2DM.
Managing your health to prevent obesity and T2DM
Obesity itself is a chronic disease and is influenced by biological, genetic and environmental factors. Like hypertension and other chronic diseases, it requires ongoing, lifelong management. Obesity is also a significant risk factor for T2DM development.
Early weight loss interventions for individuals with prediabetes and T2DM can reverse the disease and prevent long-term complications. People at risk should consult their general practitioner for guidance and direction to appropriate assistance and support.
