Physicians have long noticed that though obesity is connected to diabetes there are plenty of obese people who never develop diabetes. That observation has recently been studied and vindicated.
According to a study that followed up 732 obese individuals for a median of 7 years recently published in JAMA (Sept. 19 issue of the Journal of the American Medical Association), excess visceral fat and insulin resistance, but not general adiposity, are both independently associated with incident prediabetes and type 2 diabetes mellitus.
"Although increased body mass index (BMI) is associated with diabetes at the population level, it does not adequately discriminate diabetes risk among obese individuals. Indeed, many obese persons appear resistant to the development of metabolic disease," the authors write.
Participants in the study, which followed 732 obese people for an average of 7 years, who later developed diabetes- were more likely than those who remained diabetes-free to have a family history of diabetes, suffer from hypertension and have an abnormally high waist circumference. BMI (Body Mass Index), which is in general use to measure obesity, was not found to be associated with higher risk.
This study validates previous studies that have shown that abdominal visceral fat specifically increases insulin resistance and raises the risk for the development of diabetes.
By recognizing that direct causes of increased risk, we enable direct targeting of those causes. In this case obviously both weight reduction and physical exercise aimed at reducing waist circumference, would both be extremely beneficial at reducing the risk of developing diabetes in high risk obese patients.
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