March 15, 2009

Obesity and Diabetes Mellitus

This will be a post related to Medicine, so do give it the skip if you aren't interested. Lol.

Classes have just restarted and I'm already missing the holidays. :P

Anyway, during PBL today, the doctor asked us the relation between obesity and diabetes or in other words, how can obesity lead to diabetes? I remember I read a journal about it once, some time last year. Haha. The only words which I could recall just now was something about "the cells can't really use the insulin released", so I simply kept quiet. When I got back home, I looked it up again. And yes, I'm on the right track. ;) I'll share it here for those interested.

Normally, glucose homeostasis is maintained by several mechanisms, namely insulin secretion, insulin action, hepatic glucose production and breakdown of glucose by cells. There are several cells in the body which are exquisitely sensitive to the action of insulin like the adipose tissue and muscles especially. So, in the fed state, insulin is released, glucose is taken up by these cells and there is inhibition of hepatic glucose synthesis. Likewise, in the fasting state, insulin synthesis is brought down to the basal level, hence causing inhibition of glucose synthesis to a lesser degree, just enough to maintain the normal blood glucose level which is about 120mol/dL.

In obesity, there's an increase in adiposity, which causes glucose intolerance due to insulin resistance. There's a decrease in the cellular sensitivity to insulin action i.e. the cells can't respond normally to basal levels of insulin. At the early stages, this phenomena can be compensated by the pancreatic beta cells, by increasing the secretion of insulin causing hyperinsulinemia. But, if no intervention takes place, eventually these cells will be exhausted and are no longer able to produce insulin, hence causing diabetes mellitus.

Obesity has now become one of the major dilemmas of the medical world. Not only it is a risk factor for diabetes, it also a pronounced cause of cardiovascular diseases like atherosclerosis and hypertension. The best way to overcome this is not by using drugs or surgeries, but a change in lifestyle. Sounds simple right? I don't think so. People are lazy nowadays. Haha.

Anyway, I think that reading up about something and writing about it (not copy-pasting), can really help make the knowledge embed in your (or in this case, mine) long term memory. Give it a try. ;)


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