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Obesity and type 2 diabetes

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It is apparent to any health professional who treats patients with obesity or type 2 diabetes that the two conditions are associated, and the importance of their interaction is heightened by the unprecedented increases in the incidences of obesity and type 2 diabetes on a global scale. The term 'diabesity' has been introduced to emphasise the inter-relationship between the two conditions.

The risk of type 2 diabetes is significantly increased in overweight people (body mass index (BMI) 25-29.9kg/m2) and even more dramatically in those who are obese (BMI >30 kg/m2). Central obesity (conveniently measured by waist circumference) is considered to be the principal risk factor for the development of type 2 diabetes, whereby excess fat is deposited intra-abdominally (visceral fat), including in the liver, pancreas, and skeletal muscle.

Not all obese people develop diabetes and, if fat is deposited subcutaneously rather than intra-abdominally, this may be a protective feature.1 In addition, not all patients with type 2 diabetes are obese and, clearly, other features, such as family history and ethnicity, are at play.

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