Title: Obesity and type 2 diabetes: Current scenario, causes and management strategies
Abstract:
Unhealthy diet, physical inactivity, insulin resistance, excess visceral fat, genetics (Inherited), are the major causes of obesity and diabetes, two chronic metabolic diseases, often grouped as metabolic syndrome. Epidemic of obesity and diabetes are increasing worldwide dramatically and silently impacting billions of people annually. The term diabesity is used to describe the coexistence and combined impact of these 2 diseases. Both are closely interlinked, type 2 diabetes (T2D) increasing linearly with an increase in body mass. Obesity refers to an abnormal or excessive fat accumulation that poses a risk to health. Obesity is often measured using body mass index (BMI) - a person's weight in kgs divided by the square of their height in meters (kg/m2). An individual of BMI 30 or higher is called an obese. Obesity epidemic has emerged as one of the most pressing challenges of the 21st century has reached epidemic proportions due to rapid urbanization and industrialized food systems. WHO (2026) states that more than 1 billion people (1 in 8 individuals), are currently living with obesity worldwide. The prevalence of global adult obesity has more than doubled and adolescent quadrupled between 1990 and 2024. Obesity poses a major risk for serious noncommunicable diseases (diabetes, cardiovascular disease, hypertension and stroke and cancer), leading to premature deaths, and reducing the overall quality of life. Diabetes or diabetes mellitus (DM) is a long-lasting (chronic) metabolic disease resulting from defects in the pancreatic hormone-insulin (secretion, action or both). Globally 1 in 9 people (590 million) are diabetics, with over 43 to 50% remains undiagnosed (252 million). T2D is escalating rapidly worldwide at a rate of 46% which is projected to reach 853 million by 2050. India remains one of the world's largest epicentres for diabetes, where in over 101 million Indians are living with diabetes and 136 million are pre-diabetics. Currently, over 40 million Americans have diabetes and 115 million live with pre-diabetes. Both these metabolic disorders pose huge financial burden, though obesity is vastly more prevalent, but diabetes is more immediately serious due to its severe impact on the host's immune system. Global health burden for diabetes now exceeding USD 1 trillion dollars. Diagnosis of diabesity is made by measuring BMI (>30 kg/m2), waist circumference (>40 inches for men and >35 inches for women) or ratios of waist-to-hip/ waist - to – height (for OBESITY); Hb1c (>6.5%), blood sugar levels (fasting >126 mg/dL; pp 2 hour > 200 mg/L), and oral glucose tolerance test (> 200 mg/dL), and clinical symptoms (extreme thirst, frequent urination, fatigue, weight loss, blurred vision, slow healing wounds, and recurring yeast UTI) (for DIABETES). Diabesity can be managed through drugs (tripeptide, semaglutide and liraglutide), lifestyle changes (diet, exercise, longer sleep), bariatric surgery and vaccination. Recently, a single dose of DNA injection has shown long-lasting weight loss and blood glucose control in mouse. Obesity and diabetes, the two rapidly spreading preventable chronic metabolic epidemics (diabesity epidemic), also known as global pandemics, requires a coordinated worldwide effort for their management through medication, exercise, diet and educating the younger generation involving i.e., involving schools at the primary and secondary levels.
