What to know about obesity and diabetes

The relationship between obesity and diabetes is close. Obesity and excess weight are two main risk factors for developing type 2 diabetes. 

Obesity affects about 42% of adults in the United States based on data from 2017–2020. Around 80–90% of people with type 2 diabetes have obesity or a higher body mass index (BMI). 

According to the American Heart Association, each year, among the new diabetes cases registered, about half of them have a connection with obesity.

In this article, we discuss how obesity or a higher BMI can increase your risk of type 2 diabetes, how to manage both conditions, and the available treatment options. 

How does having a higher BMI relate to diabetes?

Body mass index (BMI) indicates the amount of fat in your body. You can calculate it by dividing your weight in kilograms (kg) or pounds (lb) by the square of your height in meters (m) or feet (ft). Experts use BMI to calculate how much fat you have in your body. But it is an imperfect measure, and they should consider other factors when assessing body mass.

However, having more body fat links to having a higher risk for diabetes.

Does obesity contribute to type 1 or type 2 diabetes?

Obesity has an association with both type 1 and type 2 diabetes. But the way obesity affects both types is different. 

The main difference between these two types of diabetes is that type 1 is genetic and tends to appear in children and adolescents, while type 2 is mainly due to certain lifestyle choices and usually appears in adults. 

Type 1 diabetes is due to an autoimmune reaction that stops your body from making insulin — a hormone that helps the body turn sugar and food into energy. Insulin resistance is a key factor in type 2 diabetes, along with a decrease in insulin secretion.

Research has shown obesity to be a primary risk factor for type 2 diabetes, but experts do not regard it as a major complication in people with type 1 diabetes. Experts historically considered diabetes a disease of lean people.

However, a 2021 study points out that obesity and a higher BMI have increasingly become more common in people with type 1 diabetes. 

According to the 2021 study, up to 37% of people with type 1 diabetes also have obesity.

Obesity can lead to the development of prediabetes and type 2 diabetes. It is common in people with type 2 diabetes. In fact, 89% of adults in the United States with diabetes have a higher BMI or obesity, according to the National Diabetes Statistics Report.”

Having excess fat around your tummy contributes to inflammation, which can lead to type 2 diabetes. Inflammation plays a key role in the development of diabetes, according to 2019 research. 

Additionally, inflammation contributes to insulin resistance. Insulin resistance happens when the cells in your body can’t use insulin well to take the sugar from your blood. 

What are the symptoms of diabetes?

The symptoms of diabetes include:

• fatigue
• frequent urination 
• excessive thirst
• blurry vision
• cuts and wounds that take longer to heal
• itching in your genital area
• tingling and numbness in your hands and feet 

Serious symptoms of type 2 diabetes include:

• headache
• dizziness
• sweating
• shaking
• difficulty thinking
• irritability 
• rapid heartbeat

If you experience these symptoms, call a healthcare professional or visit your nearest emergency service.

Does effective weight management ‘cure’ diabetes?

Diabetes has no cure, but people can manage it well. Maintaining a moderate weight or losing just 5–10% of your body weight can help your diabetes go into remission. Your diabetes goes into remission when you don’t experience any symptoms. However, the condition is still present. 

Experts consider diabetes is in remission when your A1C levels are below 6.5%.

To lower your A1C levels, certain lifestyle factors and medications can help. Lifestyle strategies that can help you reach and maintain a moderate weight include:

• Exercising: Experts recommend 150 minutes of physical activity per week or 30 minutes of exercise 5 days a week. It could be a brisk 15-minute walk twice daily, 5 days per week.
• Eating a balanced diet: Consider eating foods and drinks low in carbs and sugar and a diet high in vegetables, lean meats, and whole grains. 
• Reducing stress: Stress can lead to inflammation. You can consider doing meditation and yoga to help you manage stress.

What treatments will doctors offer?

Healthcare professionals may prescribe medications to help you manage diabetes.

Medications to treat type 1 and type 2 diabetes are similar in that they seek to keep blood sugar in a typical range, but they differ based on the specific causes of each type. 

Type 1 diabetes medications

Insulin is the most common medication to treat type 1 diabetes. Doctors administer insulin via injections or through a pump. There are several types of insulin:

Short-acting insulin:

• Humulin R U-100
• Novolin R FlexPen
• Novolin R ReliOn
• Novolin R FlexPen ReliOn.

Rapid-acting insulin:

• Admelog
• Humulin R U-500 Kwikpen (Afrezza)
• Fiasp
• Humalog
• Lyumjev
• NovoLog

Intermediate-acting insulin: insulin isophane (Humulin N U-100, Novolin N, and Novolin N FlexPen).

Long-acting insulin:

• insulin degludec (Tresiba) 
• insulin detemir (Levemir) 
• insulin glargine (Lantus)

Combination insulin:

• insulin Lispro Protamine 75/25
• Novolog Mix 70/30

Pramlintide (Symlin) is another medication used to treat type 1 diabetes. Doctors give it in the form of an injection.

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Type 2 diabetes medications

Medications for type 2 diabetes help the body use insulin better. 

These drugs, which you can take by mouth or via an injection, include:

• Alpha-glucosidase inhibitors: acarbose (Precose) and miglitol (Glyset)
• Amylin analogs: pramlintide (Symlinpen 60)
• Dipeptidyl peptidase 4 inhibitors: alogliptin (Nesina), linagliptin (Tradjenta), sitagliptin (Januvia), and saxagliptin (Onglyza)insulin
• Metformin: (Fortamet and Glumetza)
• Meglitinides: nateglinide (Starlix) and repaglinide (Prandin)
• Glucagon-like peptide 1 receptor agonists: semaglutide (Ozempic) and liraglutide (Saxenda)
• Gastric inhibitory polypeptides: tirzepatide (Mounjaro)
• Sodium-glucose cotransporter-2 inhibitors: canagliflozin (Invokana), dapagliflozin (Farxiga), empagliflozin (Jardiance), and ertugliflozin (Steglatro)
• Sulfonylureas: glimepiride (Amaryl), glipizide (Glucotrol), and glyburide (Glynase)
• Thiazolidinediones: pioglitazone (Actos)

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Surgery

If medications and lifestyle strategies have not helped you maintain a moderate weight or keep your blood sugar levels steady, your healthcare professional may suggest surgery. 

Surgery for weight reduction and diabetes management is considered the last line of treatment. The types of surgery include procedures to reduce the size of your stomach, such as gastric bypass and gastric sleeve.

Learn more about bariatric surgery here.

Summary

Obesity has a close association with diabetes. Obesity and having a higher BMI are the main risk factors for developing prediabetes and type 2 diabetes. People with type 1 diabetes are increasingly becoming obese or overweight, according to recent research.

Diabetes has no cure, but it can go into remission with lifestyle strategies, such as reaching and maintaining a moderate weight, taking prescribed medications, and other medical interventions like surgery.

Talk with a healthcare professional about the best treatment path if you have diabetes and obesity or if you are concerned about your risk of developing diabetes. 

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.