Excess insulin and hypoxia, linkages to obesity and type 2 diabetes

Abstract

Obesity, a pandemic in the U.S. [1], is continuing to worsen. In 2013-2014, more than a third of American adults (37.7%) were obese, with a body mass index (BMI) of ≥30. That figure represents an increase of 7.2% from the years 1999-2000, roughly equivalent to 16 million people. During the same period in the U.S., the prevalence of the morbidly obese (BMI ≥40) increased from 4.7% to 7.7% in 2013-2014, representing 6.7 million. Perhaps not surprisingly, bariatric surgery grew from 158,000 cases in 2011 to 216,000 in 2016 [2].Obesity, the accumulation of excess body fat, is linked to many chronic conditions or diseases as a cause of comorbidities, which include asthma [3], type 2 diabetes [4,5], rheumatoid arthritis [6], cardiovascular diseases [7,8], cancer [9], depression [10,11], and dementia [12,13]. On average, an obese person incurred $3,429 more healthcare costs (in 2013 dollars) from 2006 to 2013 than did a non-obese person [14]. Beyond that, the social costs of obesity are incalculable.Despite enormous efforts to curtail the rising trend in obesity, the war against obesity is losing its footing, with no clear strategy to overcome this challenge in sight [15]. This is not because the causes of obesity are unknown; the WHO's International Statistical Classification of Diseases and Related Health Problems version 10 (ICD-10) identified excess calories and drugs as obesity's most important causes. But homocentric theories of obesity at both macro and micro levels seem to have prevailed and misguided the practice of obesity control. At the macro level, for example, the homeostatic theory of obesity has suggested "a circle of discontent" linking weight gain, body dissatisfaction, negative affect, and overconsumption, resulting in strategies to overcome the obesity epidemic such as putting a stop to victim-blaming, stigma, and discrimination and revalorizing the thin ideal, among others [16]. At the micro level, extensive studies of genetic and biochemical mechanisms have linked excess nutrients to obesity as a byproduct of metabolism, but the linking mechanisms are still poorly

Деякі Аспекти Медикаментозної Терапії Цукрового Діабету 2-Го Типу У Людей З Надмірною Масою Тіла

“…Роль дисфункции бета-клеток в патогенезе СД 2-го типа известна, в связи с чем следует избегать их чрезмерной стимуляции. Важно подчеркнуть, что гиперинсулинемия сама по себе способствует увеличению массы тела, дислипидемии и атеросклерозу [51,72,112,113]. С учетом изложенного при прочих равных условиях преимущество имеют препараты, действие которых не связано со стимуляцией бета-клеток.…”