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[IPk] Type 2 and obesity

About type 2 and obesity....

It is indicated that if type 2s lose weight, many of them will find their 
diabetes easier to control--'course, the same goes for overweight type 1s. 
The more you weigh, the more cells you have, the more insulin/insulin 
sensitivity you need to make sure blood sugars are good, but the trickier 
absorption can get. One theory I've come across re causes of type 2 includes 
the idea that for each person, there's a weight threshold that can be 
reached and then *ping*! Whatever goes wrong with the insulin receptors on 
the cells does its thing because the weight threshold has been reached, in 
combination with other risk factors already in place. I have just spent some 
time looking for a reference to that theory on-line and haven't found one, 
but I could have used bad search terms. Moving swiftly on....

In the US it used to be thought that African-Americans, Hispanic Americans, 
and others of non-white racial background were at greater risk for type 2 
because of purely genetic factors. However, the increasing incidence of MODY 
(maturity-onset diabetes of the young, a term now going out of use because 
type 2 is getting common enough among young people that its 'unusualness' is 
decreasing) among black teenagers sparked some more research. Conclusions: 
African-Americans are culturally more likely to eat less nutritious, fattier 
food because of family traditions and economic factors. In developed Western 
societies, it tends to be those who are wealthy enough to afford fresh fruit 
and veg, less fatty (better butchered) meats, and gym memberships who are 
thin and intentionally physically active, while the poor tend to eat 
cheaper, highly processed, less healthful foods and are unable--in many 
cases because of working 2 or 3 minimum wage jobs--to exercise regularly to 
good effect. And in America, the poorest tend to be recent immigrants 
(especially those who cannot speak English, such as Hispanic immigrants, who 
must take menial, low-paying jobs) or those historically discriminated 
against (like African-Americans). What 'class' means to Britain, 'race' 
means to America.

Interestingly, the incidence of type 2 in China can be correlated to 
increasing Westernization (er, Americanization) of diet and exercise 
patterns. Type 2 was in the past not all that common in China but now it's a 
big problem that keeps getting bigger.

Here are some Medscape.com references that might be of interest:






And from sources other than Medscape:



IDDM 10 years; MiniMed pumper 6+ years
Co-ordinator, Oxford University Student Union Diabetes Network

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