Diabesity: Unravelling the Synergistic Epidemic of Obesity and Type 2 Diabetes

The diabesity epidemic has rapidly evolved from a Western health concern to a global public health emergency, transcending geographic, socioeconomic and ethnic boundaries with alarming consistency. Diabesity is more than a mere statistical association – it is a unified pathophysiological entity, characterised by insulin resistance, chronic low-grade inflammation, adipokine dysregulation, ectopic fat deposition and beta-cell dysfunction. The clinical and economic ramifications are significant, with an increased risk of cardiovascular disease, non-alcoholic fatty liver disease, sleep apnoea and several cancers. Despite a growing armamentarium of evidence-based interventions, the management of diabesity continues to face substantial clinical, behavioural, economic and policy-related obstacles. These challenges are further complicated by social and cultural contexts, particularly in low- and middle-income countries, where healthcare infrastructure and affordability constraints frequently undermine the long-term outcomes. Curbing the diabesity epidemic will require a paradigm shift – from reactive treatment to proactive, personalised and preventive care. Multidisciplinary approach is the most successful way to manage this growing worldwide epidemic with enormous impact on morbidity and mortality. This review aims to explore the epidemiology, mechanistic links, diagnostic challenges and integrated management strategies for diabesity, with a special emphasis on emerging therapeutic approaches and the Indian context.