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November 3, 2003

Type 2, Weight and Weight Loss

Question from Newcastle, England:

What is the effect of obesity on type 2 diabetes in a school age child?


Obesity has been very tightly associated with type 2 diabetes in children. When increase fat develops, especially abdominal fat, there is an increased risk of developing diabetes. There may be several reasons for that.

First, the increased fat allows for more circulating fat in the blood. The higher levels of fat may induce changes in insulin secretion. In addition, fat gets deposited into tissues that make them less sensitive to circulating insulin. This term is referred to as insulin resistance. The combination of insulin resistance and an inability to respond with increased insulin secretion results in high blood sugars in diabetes. For many people, loss of weight leads to improved insulin response and secretion. This may make diabetes easier to treat to goal or prevent people from developing the disease. Unfortunately, obesity is a chronic problem that affects people over a lifetime.

Additional comments from Jane Seley, diabetes nurse specialist:

Obesity causes more insulin resistance and therefore worsens the diabetes, leading to the need for more medication to control the blood sugar. It is no coincidence that most newly diagnosed type 2 patients are obese. Losing weight, even a little, can decrease the insulin resistance and lead to better control of the diabetes with less or no medication. I have seen this happen to many of my type 2 patients.