The incidence of diabetes is significantly higher in people who are chronically and persistently obese. Among type 2 diabetes patients, 80% are obese and 60% have abnormal glucose tolerance. Obese people are often accompanied by hyperinsulinemia, so it is believed that obesity and diabetes are closely related. Most scholars believe that the cells of obese people are insensitive to insulin, and in order to meet the metabolic requirements, the pancreatic islets must secrete insulin 5-10 times higher than normal (that is, hyperinsulinemia), and if the above level is not reached, it is manifested as diabetes. Patients often have a combination of excessive adipocyte hyperplasia, as well as fat bulking, and insensitivity to insulin, which results in hyperglycemia and leads to hyperinsulinemia because less glucose is utilized. In contrast, most people with juvenile diabetes, who have a genetic predisposition, mostly show lower than normal insulin secretion levels and insulin secretion failure, so they are different from those with obese diabetes. When people are obese, the response to endogenous or exogenous insulin is reduced. As obesity increases insulin requirements, the islets are necessarily overburdened, resulting in islet hypertrophy. The impaired glucose tolerance in obese people is due to the long-term and continuous stimulation of the pancreas. Eventually the pancreas becomes fatigued and cannot produce insulin adequately, leading to the development of diabetes. A person with diabetes caused by obesity often has a change in condition with weight loss and the metabolic function of sugar returns to normal. Therefore, for a diabetic patient with obesity, it is even more important to make efforts to lose weight. In simple terms, diabetes caused by obesity can be divided into three stages: Islet function is relatively intact: Generally, the BMI of this group of people will be greater than 32.5. Only because of the high weight causes insulin resistance, and makes the blood sugar too high. In these patients, the blood glucose can be normalized by reducing weight. If these patients need to be treated surgically, sleeve gastrectomy will be used. Islet beta cell function greater than 1/2 of normal: Since the damage to the pancreatic islets is not very severe, the patient may lose weight. If the BMI is greater than 27.5 it is possible to control blood sugar through gastric bypass surgery. Some patients can be in complete remission of diabetes. Islet beta-cell function less than 1/2 of normal: Due to the severe damage to the pancreatic islets, the patient will lose a lot of weight or lose weight. These patients cannot control their blood sugar by their own islet function, so they are recommended to be treated conservatively. Blood sugar is controlled by taking medication or (and) insulin injections. How to calculate the BMI? The damage of obesity to the pancreas is quantitative to qualitative. Don’t wait until the weight accumulates to realize the value of health.
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