Write a detailed note on Diabetes and Obesity

Diseases and Disorders due to Lifestyle Modifications

  • Diseases are prevalent in our society due to our improper way of living, conditions of stress and strain. 
  • These diseases are non-communicable and affect the person who is suffering from particular symptoms. 
  • It is an impairment of the body tissue or organ, disturbances in metabolic function which require modification of an individual’s normal life.

Diabetes Mellitus

  • Diabetes mellitus is a chronic metabolic disorder. In Greek (Diabetes – running through; Mellitus- sweet). 
  • It is characterised by increased blood glucose levels due to insufficient, deficient or failure of insulin secretion. 
  • This is the most common pancreatic endocrine disorder. The incidence of Type-1 and Type-2 diabetes is increasing worldwide.

Type-1 Insulin Dependent Diabetes Mellitus (IDDM)

  • IDDM accounts for 10 to 20% of the known diabetics. The condition also occurs in children (juvenile-onset diabetes) and young adults, the onset is usually sudden and can be life-threatening. 
  • This is caused by the destruction of ẞ-cells of the pancreas. 
  • It is characterized by abnormally elevated blood glucose levels (hyperglycemia) resulting from inadequate insulin secretion.

Causes: 

  • Genetic inheritance and environmental factors (infections due to virus, acute stress) are the cause for this condition.

Type-2 Non-Insulin Dependent Diabetes Mellitus (NIDDM)

  • This is also called adult-onset diabetes and accounts for 80 to 90% of the diabetic population. It develops slowly, usually milder and more stable. 
  • Insulin production by the pancreas is normal but its action is impaired. The target cells do not respond to insulin. 
  • It does not allow the movement of glucose into cells.

Causes: 

  • The causes are multifactorial which include increasing age (affecting middle-aged and older people), obesity, and sedentary lifestyle, overeating and being physically inactive.
  • One in every 8 individuals in India is a diabetic. 
  • The revised WHO estimates for the year 2025 is 57.2 million diabetics in India. 
  • The average age for the onset of diabetes is 40 Years, while it is 55 years in other countries. 
  • World Health Organization projects that diabetes will be 7th leading cause of death by the year 2030.

Symptoms: 

  • Diabetes mellitus is associated with several metabolic alterations. 

The most important symptoms are

  • Increased blood glucose level (Hyperglycaemia) Increased urine output (Polyuria) leading to dehydration
  • Loss of water leads to thirst (Polydipsia) resulting in increased fluid intake
  • Excessive glucose excreted in urine (Glycosuria)
  • Excess hunger (Polyphagia) due to loss of glucose in urine.
  • Fatigue and loss of weight

Prevention and Control of Diabetes

  • Diet, hypoglycaemic drugs, insulin injection and exercise are the management options based on the type and severity of the condition. 
  • The overall goal of diabetes management is to maintain normal blood glucose level.

Dietary management: 

  • Low carbohydrate and fibre-rich diets are more appropriate. Carbohydrates should be taken in the form of starch and complex sugars. 
  • Refined sugars (sucrose and glucose) should be avoided. 
  • A diet comprising whole grains, millets (jowar, bajra, ragi), green leafy vegetables, wheat and unpolished rice should be included in the diet regularly.
  • Carbohydrates is maintained to about 50 55% of the total calories. 
  • A high protein content of 10-15% of the total intake is required to supply essential amino acids. 
  • Fat content in the diet should be 15-25% of the total calories. Saturated fat intake should be reduced. Polyunsaturated fatty acid content should be higher.

Management with insulin: 

  • Commercially available insulin preparations (short and long-acting) are also used to maintain blood glucose levels.

Physical activity: 

  • Exercise plays an important role in facilitating a good control of diabetes, in addition to strengthening and toning up the muscles.

Education and Awareness: 

  • People with diabetics should be educated on the nature of the disease they have and the possibility of complications of the disease if blood sugar is not kept under control. Instructions regarding diet, exercise and drugs should be explained.

Obesity

  • Obesity is the state in which there is an accumulation of excess body fat with an abnormal increase in body weight. 
  • Obesity is a complex multifactorial chronic disease developing from the influence of social, behavioural, psychological, metabolic and cellular factors.
  • Obesity occurs if the intake of calories is more than the expenditure of energy. 
  • Overweight and obesity are conditions where the body weight is greater than the mean standard weight for the age and height of an individual. 
  • Body mass index (BMI) is an estimate of body fat and health risk.

BMI = Weight (kg) / Height (m) ²

Causes and risk factors: 

  • Obesity is due to genetic factors, physical inactivity, eating habits (overeating) and endocrine factors. Obesity is a positive risk factor in the development of hypertension, diabetes, gall bladder disease, coronary heart disease and arthritis.

Prevention and Control of Obesity

Diet Management: 

  • Low calorie, normal protein, vitamins and minerals, restricted carbohydrate and fat, high fibre diet can prevent overweight. 
  • Calorie restriction for weight reduction is safe and most effective.

Physical exercise: 

  • A low-calorie diet accompanied by moderate exercise will be effective in causing weight loss. 
  • Meditation, yoga and physical activity can also reduce stress related to overeating.

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