Dr. Jitendra Singh
Besides his wit, oratory, grit and statesmanship, Sir Winston Churchill, the most towering British Prime Minister, was adored and eulogisted by the masses for his “baby” face, “chubby” features and “plump” physique. Churchill’s obesity can thus be said to have become an asset in public career and at the same time it did not deter him from leading a disease-free life upto ripe old age of 80. The example no longer holds distinction today with an epidemic of obesity sweeping the globe and proving to be a major cause of disease and death particularly due to Diabetes, high blood pressure and heart attack.
There is now evidence to believe that in an overweight Diabetic, weight reduction may lead to a substantial fall in diabetic complications as well as mortality with possible consequent increase in lifespan. However, weight reduction has to be intentional or voluntary and not unintentional which could infact be a symptom of uncontrolled Diabetes or some other unrecognised underlying health problem.
CORNERSTONE OF TREATMENT
To a great extent, weight reduction can be considered the cornerstone of Diabetes management. In overweight individuals,weight reduction does not only help in better control of Blood Glucose/Sugar levels, blood pressure and lipid profile but it also enables significant saving by bringing down the expenditure on medication, drugs and treatment.
Better control of Blood Sugar coupled with buffer effect on high blood pressure and on risk of coronary heart disease is infact enough reason to emphasize on weight reduction in the treatment of Type 2 Diabetes Mellitus.
INTENTIONAL VERSUS UNINTENTIONAL WEIGHT LOSS
It is important to differentiate and understand the implications of weight reduction brought about by intentional or voluntary effort visavis the unintentional weight loss occurring without individual effort. While intentional weight reduction in an overweight Diabetic is indeed a healthy phenomenon, unintentional weight loss is rather unhealthy and could be the result of uncontrolled or undetected Diabetes or also sometimes that of an undiagnosed underlying complication.
An overweight Diabetic can be educated to undertake a weight reduction programme based on dietary regulations, behavioural patterns and physical exercise. Moreover, a Diabetic has to be taught to first bring his Blood Sugar levels under adequate control in order to check the unhealthy weight loss and then to practise various dietary and exercise regimens to check the unhealthy weight gain.
With some of the recent studies claiming as much as 25 percent reduction in Diabetes related mortality as a result of weight reduction in overweight Diabetics, the optimisation of body weight can be considered a basic requisite for successful diabetes treatment even inspite of the most modern and all the sophisticated medication options available today.
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