Obesity, asthma and type 2 diabetes
Overweight and obesity have reached the level of epidemic, progressing year by year. Besides the fact that people’s body shape gets worse, overweight is often accompanied by comorbidities – metabolic syndrome, coronary heart disease, cell cancer and type 2 diabetes.
Recently conducted large-scale clinical studies have established that hypoventilation syndrome and various types of asthma are associated with overweight and that usually extra weight causes their progression. Scientists have found out that asthma and diabetes can be connected to obesity through the systemic and chronic inflammation.
Not so long ago, overweight was considered a healthcare problem of the developed countries only, but more and more developing countries are facing similar health problems these days. This review explores the possible primary causes, as well as methods of management and prevention of this disease.
According to the 2015 data, obesity is responsible for over 15% of global diseases. Over 1.9 billion people of many countries of the world are overweight and over 600 million of people are obese. But the greatest concern is the growing number of overweight children under 5 years old (over 40 million worldwide).
The numbers of diagnosis of type 2 diabetes and obesity are growing equally. It was established that up to 90% of all diagnoses of type 2 diabetes were associated with high body fat percentage. Obese people are more prone to violated glucose tolerance and progression of different metabolic disorders. Combination of these factors is a precursor of severe diseases.
The distribution of fat over different organs and tissues of the human body is as important as weight gain. The BMI above 30-35 is associated with some pathologies of the heart work and type 2 diabetes. The risk of these diseases is closely connected to various types of obesity and a large waist circumference.
OBESITY AND ASTHMA
Nowadays, the number of asthma diagnosis, as well as type 2 diabetes is growing because of obesity. However, nobody knows, whether these facts are linked to each other or it is just a coincidence.
American scientists considered the connection between asthma and fat tissues in more than 100 000 people. The researchers took into account smoking, total caloric intake, as well as the level of physical activity and established a high risk of new incidents of asthma in obese patients.
Scientists found out that the increase of body weight by 1 kg per year was associated with high risk of asthma. The faster the body fat percentage increases, the higher the risk of asthma. Despite that, the researchers failed to find the direct connection between asthma and obesity during the trials on overweight patients. So it is getting clear that there must be some other factors.
«For the last 25 years, the number of obesity, type 2 diabetes and asthma cases have increased dramatically».
People, with both disorders asthma and obesity, have to use more medications, so they spend more healthcare resources than people who only suffer from obesity. Obese people with various types of asthma have dyspnea 2.5-3 time more than others do, and they use inhalers more often as well.
Such patients get in the Emergency Hospital more often than other people do. Despite the fact that overweight people with asthma suffer from asthma attacks more frequently and that they consume more healthcare resources, it seems that overweight does not affect the asthma severity.
ASTHMA AND TYPE 2 DIABETES
Asthma and type 2 diabetes are interconnected diseases, but this connection requires further investigation. The thing is that different studies are complicated by limited access to administrative database and sometimes give controversial results.
During one of the trials, studying the decrease of insulin resistance in diabetic children and adolescents, with or without asthma, scientists got strong evidence of connection between obesity and this disease. The insulin resistance in these children was 50% higher than in overweight children without asthma.
These results draw the attention of scientists and they decided to conduct additional trials, involving adult patients. They had assumed that there was a connection between the inflammation of airways and the insulin resistance.
POSSIBLE MECHANISMS OF ACTION
Despite the fact that scientists established the connection between asthma and obesity, common mechanisms of action are still unknown. According the results of clinical studies on animals and people, we may assume that mechanical and inflammatory processes affect both the appearance and progression of asthma and type 2 diabetes.
In fact, the interconnection between overweight and type 2 diabetes can be explained by influence of adipose tissue on the development of systemic inflammatory state. This model shows that the consumption of large portions of food high in fat and simple carbohydrates leads to increased number of cells, composing the fat tissue (adipocytes).
When adipocytes increase in size, the fat metabolism is violated, causing oxygen deficiency and releasing the inflammatory mediators (active oxygen and nitrogen intermediates). Such reaction of the body provokes changes of insulin resistance.
Overweight or obesity can affect asthma due to systemic inflammation. The trials revealed that the consumption of fatty food increases the risk of bronchial spasms, worsening the functions of the respiratory tract and affecting the pulmonary circulation.
Fats can cause mechanical effect on the respiratory system of people (especially in abdominal obesity). Fat tissue puts pressure on abdominal cavity and chest and violates the gas exchange in lungs. As a result, it causes an imbalance between the blood volume and the amount of air that comes into lungs.
Abdominal and subcutaneous obesity reduce the lung volume, which negatively affects the work of the respiratory and cardiovascular systems. Overweight increases the risk of airway hyperresponsiveness, and in people with BMI over 30-35, this risk is three times higher.
For the last few decades, the number of obesity, asthma and type 2 diabetes cases have increased significantly. Data, achieved during different studies, allow assuming that these states can be connected to each other through anatomic and inflammatory mechanisms.
The weight loss by means of physical exercises, diets or surgeries can reduce the symptoms of asthma and type 2 diabetes. Even the slightest weight loss improves breathing and reduces the need in medications for people suffering from asthma and obesity.
If hunger hinders to keep a diet, you can use some anorexigenic drugs. Today, Phentermine is one of the most popular appetite suppressants in the world. You can buy such medicines under the brand names – Adipex, Suprenza, Duromine and Metermine.
In conclusion, we can say that asthma and diabetes in obese people require a complex treatment, which greatly increases the healthcare costs. The combination of these three pathologies can significantly worsen a patient’s health. Doctors must focus on treatment of obesity in the first place, because this disorder is the common denominator of many medical problems.