The prevalence of diabetes mellitus is increasing worldwide, said Dr Bashar Neamat Fadheel Sahar, Specialist Internal Medicine Endocrinology, Zulekha Hospital Dubai.
Most patients with type 2 diabetes mellitus are overweight and or obese. Therefore the most important step to decrease the prevalence of diabetes is through prevention and or proper management of obesity.
Change in lifestyle and exercise on most days of the week is the cornerstone of management of obesity. However, on many occasions people find it difficult to adhere to a specific dietary programme and therefore weight loss strategies are unsuccessful.
“If we dig in depth, we will find that the appetite centre within the brain of the obese population is disturbed,” he said. In the past a lot of agents have been manufactured to treat diabetes but the problem of these agents is that they do not have a positive dual effect on sugar and body weight. The recent discovery of agents to treat diabetes and obesity simultaneously represents an important step in diabetes management. The new agents called GLP-1 agonists are now widely available in the market and they act on satiety centres in the brain in addition to their stimulatory effect on the pancreas to enhance release of insulin. Therefore, the combined effect is control of sugars and body weight. This favourable dual mode of action can be very helpful to address the concern of many people with diabetes who are struggling to lose weight but are not able to achieve their goals.
In addition to that, surgical treatment of diabetes in the form of what is called “Bariatric Surgeries” is gaining popularity nowadays and it represents an important step in the management of diabetes and can lead to diabetes remission in up to 80 per cent of patients.
“But I should stress again that the most effective way to reduce the epidemic crisis of diabetes and obesity is through primary prevention,” he added.
Each country has to put its own plans to deal with obesity and perhaps one of the best effective strategies is through classification of obesity as a “disease” so that people become more concerned about its consequences and this should result in a dramatic change in behaviour.
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