Last Update: Wednesday, August 20, 2014

Obesity and Diabetes: A Deadly Combination PDF Print E-mail
Written by Dr. David Lipschitz   
Wednesday, 12 February 2014 23:29

Type 2 diabetes is occurring with ever-increasing frequency in young adults and even children. This alarming statistic is the result of an increase in obesity and sedentary lifestyles. Reduced muscle mass and increased fat contribute to a condition known as metabolic syndrome, which is associated with insulin resistance. For reasons that are not clear, increased body fat and reduced muscle make it more difficult for insulin to pump sugar into cells.

In susceptible individuals, diabetes occurs when, despite increased insulin concentrations, blood sugar rises to abnormally high levels. Diabetes is a chronic illness affecting numerous organ systems.

These changes account for the majority of diseases accompanying diabetes and contribute to much of the suffering. The most serious is elevated cholesterol and triglycerides, which lead to wide-spread vascular disease and a high incidence of heart attacks, strokes and impaired blood supply to the lower limbs. High fat levels also cause the liver to enlarge, leading to declines in liver function.

The altered metabolism that accompanies diabetes causes the deposition of carbohydrate products in the smallest arteries called arterioles. This substance, known as sorbitol, causes changes in these vessels that provide critical blood supply to every important organ. Over time, these vessels become blocked, and blood supply to many tissues is compromised. This involvement of small arterioles is called "diabetic microangiopathy." The most important organ systems affected are the peripheral nerves, retinas and kidneys. Many diabetics suffer from peripheral neuropathy, which causes a great deal of pain and discomfort.

As the condition progresses, sensation in the lower limbs is lost, making it difficult to recognize heat, pressure or even minor injury. This leads to skin breakdown and ulcers, usually on the feet, that are very difficult to heal. Because the small blood vessels are inadequate, the problem becomes even worse and very difficult to manage. Visits to a surgeon are often necessary, special shoes are needed, and recovery is difficult. Some medications can help the pain, providing some relief, but the damage to arterioles and nerves is permanent. Nerve involvement also affects the bowel and penis.

Functional changes in the bowel occur, leading to a condition called "diabetic enteropathy." The stomach becomes partially paralyzed, causing abdominal pain and bloating. Involvement of the colon causes both constipation and explosive diarrhea, which often occur at night. Impotence is another common complication occurring because both the nerve and blood supplies to the penis are impaired.

Impaired nerve supply prevents the penis from getting the message to become erect, and impaired blood supply makes engorgement impossible. While these problems cause a great deal of suffering, it is involvement of the kidneys that leads to life-threatening illness. Chronic renal failure gradually develops, and sometimes kidney damage causes excessive loss of protein and electrolytes from the body. Kidney disease raises the blood pressure and aggravates the elevated cholesterol that occurs with diabetes, increasing the risk of heart attacks, strokes and heart failure.

It may take many years for this illness to manifest, so atrisk individual's blood sugar should be screened. If diabetes is diagnosed, it should be an urgent wake-up call for health reform. Weight loss and exercise, by decreasing fat content and improving muscle mass, can often revert metabolism to normal, making more therapy unnecessary.

If weight loss and exercise are inadequate, numerous medications are available that can keep blood sugar controlled and prevent the devastating complications of the illness. Please remember it is never ever too early or too late to pay attention to your health. Dr. David Lipschitz is the author of the book “Breaking the Rules of Aging.” To find out more about Dr. David Lipschitz visit