Obesity and Type 2 diabetes mellitus

Worldwide obesity is showing no signs of lessening and is fueling an angry outburst in numbers of Type 2 Diabetes Mellitus (T2DM).In spite of apparent links between obesity and T2DM, actual mechanisms are intricate given that some people with obesity materialize to be protected in some way from developing T2DM.Obesity and T2DM form part of the metabolic syndrome, which combined with hypertension and Dyslipidaemia result in impulsive mortality from cardiovascular disease in millions of people each year.Long-term microvascular complications from T2DM and multiple co-morbidities associated with obesity (psychological, musculoskeletal, respiratory and reproductive) also have a major adverse collision on quality of life and masquerade a mammoth financial burden on global health authorities.The relationship between obesity and diabetes is of such interdependence that term 'diabesity' has been coined.Major factors causative towards 'diabesity' include chronic overconsumption of energy-dense food, lifestyle, genetic makeup and environment play important roles in adipose tissue function or dysfunction.T2DM is characterized by impaired fat metabolism in adding up to glucotoxicity.Overconsumption of energy-dense foods results in excessive fat deposition and enhanced insulin resistance.Free fatty acids (FFAs) delivered to liver via the portal vein result in fatty liver.FFAs spill into systemic circulation result in lipotoxicity of organs such as pancreas, heart and muscles initiate a viscous cycle of fat damage, inflammation, worsening insulin resistance and beta cell insulin secretion, and eventually demonstration of T2DM.Visceral fat content is an independent predictor of insulin resistance, whilst adipokines such as adiponectin protect against obesity-induced T2DM.Further study of the precise mechanisms of lipotoxicity in development of T2DM will enable development of novel strategies to manage and prevent onset of T2DM in context of obesity.In this review, we elaborate associations between obesity and T2DM.