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Theory on T2 and overweight/obesity

Grazer

Well-Known Member
Messages
3,115
We all know the thinking of many (including HCPs) that being fat causes T2 diabetes. The fact that 80% of T2s are overweight is used to prove this. So here's a thought on the subject.
I think the 80% bit tends to make things sound too definitive; "80% is a large number and thus proves T2 is caused by this" goes the thinking .
But although 80% of diabetics are overweight or obese, over 50% of the GENERAL POPULATION are overweight or obese. In the states i think it's 60%? What I'm saying is that if the stats were "80% of the general population are overweight and 80% of T2s are overweight, then we would just be saying that a normal percentage get T2 and weight doesn't come into it. As it is, we're saying only (maybe) 60% are overweight and 80% of T2s are, but the difference isn't that great as it may sound by just saying "80% of diabetics are overweight"
We do know that being overweight increases insulin resistance, which is why overweight T2s try to lose weight. So overweight in a T2 DOES increase BGs. We all agree on that too. So it could be that T2 is purely hereditary and we develop it regardless of weight, it's just that it shows more readily with higher BGs if you're overweight, and develops more quickly to a stage where it will show as the higher BGs drive the pancreas harder. This theory would say it doesn't CAUSE diabetes, it's therefore NOT our fault if we're overweight, but it shows quicker and develops quicker. This would also explain why 80% of the overweight/obese aren't diabetic!
Just a thought, as someone who wasn't even overweight at diagnosis.
 
Prior to diagnoses, I was finding it extraordinarily difficult to reduce my weight.

Since diagnosis, by both taking medications and making lifestyle adjustments I have been able to reduce my weight considerably.

So it seems that untreated diabetes causes weight gain and weight gain causes diabetes.

It is difficult deal with the causes until you know what the causes are.
 
Hey all!

You might be right, Grazer. However, we also know that a proportion of Type 2s are actually misdiagnosed Type 1.5s (in its various forms). Unfortunately we don't know what proportion this is. My consultant told me that up to 20% of 'Type 2s' are really 1.5s of some kind, but i saw someone quoting 5% on the forum a few weeks back. My question is, how would it skew your figures if 20% of Type 2s are not Type 2 and of those, mostly the slim ones? Or is it a small enough number to be of no consequence?

The other thing I think we need to bear in mind, is that it is potentially the proportion of weight that someone has put on rather than the amount of weight that contributes to insulin resistance. So, the potential forType 2 is increased even in someone who is, say, 8 stone and not overweight, if their weight has risen relatively quickly from, say, 6 and a half stone. Apparently this is because of the proportion of the overall body weight that has increased. I only have the word of a DSN at my surgery for this, though, and she did misdiagnose me, so it might be rubbish :lol:

Smidge
 
I have said for years that a "link" isn't proof of "cause and efect" .
I'm sure there's some kind of link between obesity and T2
a long time ago, I came to think that T2 may be the cause of obesity in people whose eating habits are not extreme. Genetics plays a part too.
I'm 3rd. Or even possibly 4th in a direct line of overweight [but not Grossly] diabetic women.
Oddly, I most resemble my OTHER grandmother in build and figure, She was big, but not known to be diabetic. No-one knows for sure, she was killed in World War 11
T1 shows itself as a loss in weight. What if T2 shows a gain?
Hana
 
I think we need to be a bit careful with the numbers here, only about 4.5% (UK average) to 5.5% (England) of the general population have type 2 diabetes, of whom 80% are over weight or obese. This is a lot more significant than, as grazer said

As it is, we're saying only (maybe) 60% are overweight and 80% get T2, but the difference isn't that great as it may sound by just saying "80% of diabetics are overweight"
Click to expand...

as this suggests that 80% of the whole population will develop type 2 diabetes which is a way off the mark.

If I get time later I will work out the proportion of overweight/obese people who are diagnosed versus those of 'normal' weight based on population estimates.

I am not for a minute suggesting that an association = causation. However I do think that there is a clear link between obesity and type 2 which shouldn't be ignored as this might prove to be the key to more effective treatment in the future.
 
Just done a very quick calculation as I was interested to know!
Based on 2010 population estimates and obesity prevalence from the national obesity observatory of all the people who are obese (not including overweight but not obese) just under 20% have type 2, so therefore approximately 4x more obese people have type 2 diabetes than the general population.
I'm sure the relative percentage would decrease if we added in all over the overweight but not obese but I can't find the data for that quickly and I should be working!!
 
The Newcastle diet to reverse type 2 diabetes was based on the premise that it was fat stored in the pancreas and liver which caused insulin insensitivity.Diet the fat away and your insulin sensitivity is normalised,your blood sugars are processed correctly and hey presto instant cure for type 2.Based on my own experiences this has worked for me in the short term,we shall see what happens over time.

The problem with this approach is that you have to be storing fat in the first place before you can store it in the pancreas,however once it is stored there your increasing insulin insensitivity then turns you into a type 2 diabetic.This might explain why some people are overweight but not diabetic,while others are overweight and diabetic.The first group have not started storing fat in places like the pancreas and still retain their normal insulin sensitivity.

You have to ask what caused you to start storing fat in the first place.I am currently interested in the link between hypothyroidism and diabetes.One possibility is that hypothyroidism causes a slow down in the rate of metabolic activity which leads to fat deposition as excess calories are stored and not used.Certainly I have a number of the symptoms of an underactive thyroid (all right just about all of them) even though my thyroid test results place me only on the low side of normal.It would explain my constantly increasing weight over the years and my eventual descent into full blown diabetes.
 
I think the increase in weight can be caused by the beginnings of diabetes.

I have wondered why obese type 2's primarily put fat on round their middle. Even the pre-menopausal women. I think the middle spread is a symptom, an early warning sign that our pancreas is having trouble. Then, as we continue to spiral down towards Diabetes, our middle fat increases because the weight caused more insulin resistance and so on.

I think it is that way round because otherwise, why dont we put weight on everywhere? Or on our bums and hips like most obese women? It is specifically visceral fat we put on, which indicates our food is being snatched by our insulin problem and laid down as fat improperly.

I also have a theory that this pre-diabetic stage can show we are malnourished at this point, causing us to crave food which we cant absorb and use properly because our insulin grabs it, leading to more eating and feeling unsatisfied, and weak, and ill. But I have no proof of this, just my own experience and observations.
 
Funnily enough, although I'm not classed as overweight or obese, I, after being a skinny for years began putting weight on around my middle after I had a hysterectomy and became menopausal.
 
Grazer said:
But although 80% of "overweight or obese people" may become T2,
Click to expand...

Not true Grazer, only 20% of obese people may become diabetic which is why being obese does not cause diabetes.

Why are we even discussing this, being obese DOES NOT cause diabetes. If you get the stats mixed up, then you can hardly blame Joe Public when they get things wrong, can you.
 

Understand why you say this, because in my original post I explained my proposition really badly! What I was trying to say is that "although 80% of diabetics may be overweight" at diagnosis, and actually said "80% of overweight may be diabetic", so apologies! Point I was making therefore is that although 80% of diabetics are overweight over 50% of the general population are ALSO overweight- hence my comment about the 80% not sounding so remarkable in that context; in fact in USA 80% plays nearly 60%
Hopefully that's clarified it! We really WOULD have an epidemic if 80% of the overweight were diabetic!
 
I've edited my first post now to say what I meant! Only the second from last sentence of the original post showed I knew what I meant, so I left that!
 
Stephen
I don't think it invalidates your suggestion of no correlation but that IDF figure for UK diabetes prevalence seems to be too low. as I said on another thread, I can't see why the UK thinks they have fewer people undiagnosed than do the other countries. It's not as if there is a systematic screening process.
For France, Germany, Italy, Spain and the UK there is a report from the LSE which uses perhaps more realistic figures and has a graph showing prevalence and obesity levels in those countries.(with ref as to where they got the figures from)They are still not strictly comparable since the UK fig includes children 0-18years and the others don't. To complicate things further the obesity rates are taken from self-reports except for the UK which is based on actual measurements.
http://www2.lse.ac.uk/LSEHealthAndSocia ... poster.pdf
It would be nice if everyone collected stats in the same way.
 
phoenix said:
Stephen
I don't think it invalidates your suggestion of no correlation but that IDF figure for UK diabetes prevalence seems to be too low.
Click to expand...

Actually, I mucked up the dataset, which is why I deleted it. I'll try and do it properly and post the results.

I agree that the IDF results are noisy, but all samples have errors, and I've got some meaningful correlations with some other data.
 
OK. So I got the full dataset, and replotted the graph.

It appears that there is a reasonably strong correlation between "% of people with BMI>30" and "% of people with diabetes".



Data is plotted for all 191 countries in the Interactive Diabetes Atlas, against WHO obesity figures.

The r squared suggests that about 25% of the distribution of diabetes could be accounted for by obesity. If I'd only included women, the correlation is even stronger (r squared = 0.3).

Considering that, as Phoenix says, the diabetes data is largely self-reported (and includes T1s), I think that this is a strong correlation.

Basically just telling us what we already know though... (some) fat people get diabetes.
 
Notice where the line crosses the axis.

Even if no-one had a BMI of over 30, 5% of the population (on average) will still catch the diabetes.

That must include the T1s and the skinny-Grazer like T2s.
 
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