Abdominal Obesity vs. Type 2 Diabetes: Beyond Body Weight

Obesity is frequently linked to metabolic complications that increase the risk of type 2 diabetes and cardiovascular disease. However, obesity is a very heterogeneous condition as not every overweight/obese patient develops metabolic complications leading to type 2 diabetes. Conversely, some individuals with a normal weight and body mass index can nevertheless be at high risk of type 2 diabetes because of their abdominal obesity and the metabolic abnormalities it causes. In this regard, several epidemiological studies in the last decades have stressed that body fat distribution plays a greater role in obesity-related complications than excess body fatness per se. The specific location of body fat is more important than the overall quantity of body fat. In light of this, most experts now agree that a high amount of abdominal fat—visceral fat in particular—increases the risk of type 2 diabetes, cardiovascular disease, and related mortality.

Key points

• Changes in human behaviour and lifestyle over the last century have spurred a dramatic increase in the incidence of obesity and type 2 diabetes worldwide.
• Because obesity and diabetes are closely linked, the term “diabesity” has been coined to illustrate the interdependence of these two diseases.
• Obesity and type 2 diabetes frequently occur together and the majority of patients with type 2 diabetes are or have been obese.
• Besides genetic susceptibility, obesity is the most important risk factor for type 2 diabetes.
• Lifestyle changes are the best way to prevent obesity and slow this worldwide epidemic.

Read more on Obesity and Type 2 Diabetes.

Key points

• The fast, simultaneous growth of obesity and type 2 diabetes has led to the coining of the term “diabesity” to illustrate the close relationship between these two diseases.
• A preferential accumulation of abdominal adipose tissue has been linked to glucose intolerance, hyperinsulinemia, and insulin resistance, which are metabolic complications predictive of increased type 2 diabetes risk.
• Using simple tools such as waist circumference to measure visceral adiposity can help assess type 2 diabetes risk independent of relative weight (BMI).
• These findings underscore the need to go beyond simple measurement of total body weight and BMI when evaluating type 2 diabetes risk in patients.

Read more on Abdominal Obesity and Type 2 Diabetes.