How does Diabesity begin and progress?

It is believed that Diabesity is an autoimmune, inflammatory disorder involving your body’s innate immune system. Your ‘innate immune system’ is your first-line of defence against anything your body thinks is harmful including infection or foreign substances. Inflammation is your body’s way of dealing with these ‘attacks’. In a healthy person, inflammation is temporary and your body soon returns to normal. In the case of autoimmunity, however, your body mounts an attack against itself and becomes stuck in a continuous loop of chronic inflammation. Recent research suggests that Diabesity is characterised by chronic, low-grade inflammation and a continuous stimulation of your immune system. The inflammation that Diabesity brings is not usually accompanied by infection or the other usual signs of autoimmunity, but seems to have its own unique features.

What causes Diabesity?

The answer: Western lifestyle. Studies clearly show that wherever a western lifestyle is adopted, Diabesity soon follows due to:

• Dietary toxins such as refined wheat, fructose and industrial seed oils
• Environmental toxins and heavy metals
• Micronutrient deficiencies (especially Magnesium and Vitamin D)
• Chronic stress (emotional, psychological, physiological)
• Altered gut bacteria (caused by antibiotic use, poor diet)
• Sedentary lifestyle

Of course genetics play a part in Diabesity, however evidence suggests that even those genetically predisposed need to be exposed to environmental factors listed above to become ‘diabese’. Environmental factors (together with or independent of genetics) cause both inflammation and obesity, both strongly associated with Type 2 Diabetes (T2DM). Obesity however, does not necessarily mean Diabetes. Evidence now shows that not all people who are obese have metabolic dysfunction, strangely, obesity could even be the body’s way of attempting to protect against the damage done by a modern lifestyle.

It’s all down to Inflammation

Inflammation however, nearly always accompanies obesity and Diabetes and is capable of causing Diabesity even if someone is a healthy weight. This is obvious when you study the presence of T2DM in the relatively lean Asian populations. This explains why thin people can have all of the metabolic problems commonly associated with obesity, in fact these cases of T2DM may be the most severe, because they lack whatever protective adaptation obesity may offer. Inflammation alone directly contributes to every metabolic dysfunction associated with Diabesity:

• leptin resistance
• impaired fat and glucose metabolism
• insulin resistance and
• beta-cell destruction (Pancreatic cell that store and release insulin)

Inflammation can be considered the root of the Diabesity epidemic.

The fat connection

Most people know that the inability to break down glucose is behind Diabetes yet they may not realise that Diabetes also involves difficulty in breaking down fats. In healthy people, your body releases stored fats, which are burned to create energy. In the ‘diabese’ however, inflammation, leptin resistance and cellular damage means your body’s cells are not able to efficiently burn fats. The excess fats then “spill over” into non-fat tissue where they don’t belong; Liver, Pancreas and Skeletal Muscles. This is called lipotoxicity and has been shown in studies to cause Insulin Resistance and increase the risk of T2DM.

What is Leptin?

Undoubtedly inflammation and obesity cause Leptin Resistance – a hormone produced by body fat which tells the brain to decrease appetite, increase metabolic rate and increase physical activity. As you accumulate more fat, you secrete more Leptin. This causes more fat to be burned. Weight gain is caused by Leptin Resistance. Leptin Resistance and inflammation contribute to impaired fat and glucose metabolism, which in turn cause Insulin Resistance – the main characteristic of Metabolic Syndrome and T2DM. The result is fully-fledged Type 2 Diabetes, an autoimmune, inflammatory disorder triggered by modern lifestyle, influenced by genetics, and characterised by impaired glucose and fat metabolism and fat hormone resistance.

More to come…

Why do some obese people never develop T2DM, yet some slim people do? Next time we'll look at this important question so stay tuned …

See also Part 1 of our series The Modern Day Health Epidemic that you should know about See also Part 2 of our series Diabesity: Myths that kep you sick See also Part 4 of our series Diabesity: How come I’ve got Type 2 Diabetes? I’m not fat!!!