AUTHOR:-DR PREMANIDHI PANDA,M.D(MED),HON PHD IN DIABETES(USA),MRCP,FRCP
Prof. Panda DIABETES CENTRE,INDIA
WEB:-drpandadiabetes.com
INTRODUCTION:- Diabetes mellitus, often simply referred to as diabetes—is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced.
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health, leading to reduced life expectancy and/or increased health problems.[1][2] In Western countries, people are considered obese when their body mass index (BMI),[3] a measurement obtained by dividing a person's weight by the square of the person's height, exceeds30 kg/m2, with the range 25-30 kg/m2 defined as overweight. Some East Asian countries use stricter criteria. Obesity increases the likelihood of various diseases, particularly:-
(1) heart disease,
(2) type 2 diabetes,
(3) obstructive sleep apnea,
(4) certain types of cancer,
(5) osteoarthritis
Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications, or psychiatric illness.
CAUSES:-
 
*1 Diet
  2 Sedentary lifestyle
  3 Genetics
  4 Other illnesses
  5 Social determinants
 6 Infectious agents:- An association between viruses and obesity has been found in humans.

obesity is a key player in the development of type 2 diabetes, but exactly how excess weight  causes the disease isn't clear. “Diabetes and obesity are the biggest public health challenge of the 21st century.” India is heading towards a diabetic explosion with 70 million people. Obesity has reached epidemic proportions in India in the 21st century, with morbid obesity affecting 5% of the country's population. As of 1999, diabetes affected 16 million (six percent) of Americans – an increase of 40 percent in just ten years.
*In  USA  the obesity rate climbed from 12 percent to almost 20 percent.
* In  2014 the diabetes and obesity rates increased 6 percent and 57 percent  accordingly.
*Every three seconds, someone is diagnosed with diabetes.
* Both diabetes and obesity risk factors are often associated with race, age, and family history, it’s becoming more and more clear that the conveniences of modern life also contribute to the development of both diseases. For example,
* sedentary lifestyles
*high fat, high energy diets (think “Super Size Me”) and convenient foods are known to lead to obesity – but do they also cause diabetes?
*Most Important  role of  junk foods has role in diabetes and obesity.
*In India Fast food is the root cause as Because:-
(1)Children’s are thinking Home Made foods are old fashion.
(2)Consume JUNK Foods As it is modern food  & Fashionable.
(3)Inspired By Advertisement.
(4)Eat More when they are lonely.
(5) If you are overweight, even a small weight loss (five to 10 percent) can prevent diabetes - or prolong the chance that you will develop the  Disease.
Link Between Obesity and Diabetes:-
*Type II diabetes, about 80 to 90 percent are also diagnosed as obese. overweight places extra stress on your body in a variety of ways, including your body’s ability to maintain proper blood glucose levels.
*overweight can cause your body to become resistant to insulin.
* If you already have diabetes, this means you will need to take even more insulin to get sugar into your cells.
* And if you don’t have diabetes, the prolonged effects of the insulin resistance can eventually cause you to develop the disease.
* once you begin taking insulin to treat diabetes, you really don’t need as much food. Since your body is using the food properly, rather than wasting it,

* Modifying your diet will help you prevent the weight gain often associated with taking insulin. In addition, be sure you monitor your blood glucose levels on a regular basis.

HOW  OBESITY   TREATED:-
Lifestyle changes, such as eating fewer calories and being physically active. Medicines and weight-loss surgery also are options for some people if lifestyle changes aren't enough.

For Adults

• Try to lose 5 to 10 percent of your current weight over 6 months. This will lower your risk for coronary heart disease (CHD) and other conditions.
• The best way to lose weight is slowly. A weight loss of 1 to 2 pounds a week is do-able, safe, and will help you keep off the weight. It also will give you the time to make new, healthy lifestyle changes.
• If you've lost 10 percent of your body weight, have kept it off for 6 months, and are still overweight or obese, you may want to consider further weight loss.

For Children and Teens

• If your child is overweight or at risk for overweight or obesity, the goal is to maintain his or her current weight and to focus on eating healthy and being physically active. This should be part of a family effort to make lifestyle changes.
• If your child is overweight or obese and has a health condition related to overweight or obesity, your doctor may refer you to a pediatric obesity treatment center.

Lifestyle Changes
Lifestyle changes can help you and your family achieve long-term weight-loss success. Example of lifestyle changes include:

• Focusing on balancing energy IN (calories from food and drinks) with energy OUT (physical activity)
• Following a healthy eating plan
• Learning how to adopt healthy lifestyle habits

   Calories

Cutting back on calories (energy IN) will help you lose weight. To lose 1 to 2 pounds a week, adults should cut back their calorie intake by 500 to 1,000 calories a day.

• In general, having 1,000 to 1,200 calories a day will help most women lose weight safely.
• In general, having 1,200 to 1,600 calories a day will help most men lose weight safely. This calorie range also is suitable for women who weigh 165 pounds or more or who exercise routinely.

These calorie levels are a guide and may need to be adjusted. If you eat 1,600 calories a day but don't lose weight, then you may want to cut back to 1,200 calories. If you're hungry on either diet, then you may want to add 100 to 200 calories a day.

Healthy Eating Plan

A healthy eating plan gives your body the nutrients it needs every day. It has enough calories for good health, but not so many that you gain weight.
A healthy eating plan is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. Following a healthy eating plan will lower your risk for heart disease and other conditions.
Healthy foods include:

• Fat-free and low-fat dairy products, such as low-fat yogurt, cheese, and milk.
• Protein foods, such as lean meat, fish, poultry without skin, beans, and peas.
• Whole-grain foods, such as whole-wheat bread, oatmeal, and brown rice. Other grain foods include pasta, cereal, bagels, bread, tortillas, couscous, and crackers.
• Fruits, which can be fresh, canned, frozen, or dried.
• Vegetables, which can be fresh, canned (without salt), frozen, or dried.

Canola and olive oils, and soft margarines made from these oils, are heart healthy. However, you should use them in small amounts because they're high in calories.
You also can include unsalted nuts, like walnuts and almonds, in your diet as long as you limit the amount you eat (nuts also are high in calories).
Foods to limit. Foods that are high in saturated and trans fats and cholesterol raise blood cholesterol levels and also might be high in calories. Fats and cholesterol raise your risk for heart disease, so they should be limited.
Saturated fat is found mainly in:

• Fatty cuts of meat, such as ground beef, sausage, and processed meats (for example, bologna, hot dogs, and deli meats)
• Poultry with the skin
• High-fat dairy products like whole-milk cheeses, whole milk, cream, butter, and ice cream
• Lard, coconut, and palm oils, which are found in many processed foods

Trans fat is found mainly in:

• Foods with partially hydrogenated oils, such as many hard margarines and shortening
• Baked products and snack foods, such as crackers, cookies, doughnuts, and breads
• Foods fried in hydrogenated shortening, such as french fries and chicken

Cholesterol mainly is found in:

• Egg yolks
• Organ meats, such as liver
• Shrimp
• Whole milk or whole-milk products, such as butter, cream, and cheese

Physical Activity

Being physically active and eating fewer calories will help you lose weight and keep weight off over time. Physical activity also will benefit you in other ways. It will:

• Lower your risk for heart disease, heart attack, diabetes, and cancers (such as breast, uterine, and colon cancers)
• Strengthen your heart and help your lungs work better
• Strengthen your muscles and keep your joints in good condition
• Slow bone loss
• Give you more energy
• Help you relax and better cope with stress
• Allow you to fall asleep more quickly and sleep more soundly
• Give you an enjoyable way to share time with friends and family

The four main types of physical activity
(1) Aerobic  Exercise,
(2) muscle-strengthening,
(3) bone strengthening.
(4)Bone  stretching. You can do physical activity with light, moderate, or vigorous intensity. The level of intensity depends on how hard you have to work to do the activity.
In light Exercise  a “YOGIC OROCESS”  KNOWN AS KAPALAVATI ASANA” IS A BOON TO MAINTAIN
HEALTHY.
Many Persons do  150 to 300 minutes (2 hours and 30 minutes to 5 hours) of moderate-intensity activity per week, such as brisk walking.

If you have a heart problem or chronic disease, such as heart disease, diabetes, or high blood pressure, talk with your doctor about what types of physical activity are safe for you. You also should talk with your doctor about safe physical activities if you have symptoms such as chest pain or dizziness.

Types of Exercise IN CARDIO:-

Your workout plan will generally include these two main kinds:

1. Cardiovascular or aerobic exercise. This is the type that benefits your heart most. Examples include walking, jogging, jumping rope, bicycling, skiing, skating, rowing, and aerobics or cardio classes. These strengthen your heart and lungs. Over time, aerobic exercise can help your blood pressure and improve your breathing, and then your heart won't have to work as hard during exercise.

Strength training. These exercises tone and build up your muscles. You may use hand weights, weight machines at a gym, or your own body weight. Typically, you do several sets of each exercise, and then let those muscles rest a day or two between sessions.

If You Have Heart Failure: 7 Tips

1. Pace yourself. Be sure to balance activity with rest.
2. Avoid isometric exercises, such as pushups and sit-ups. Isometric exercises involve straining muscles against other muscles or against a steady object.
3. Don't exercise outdoors when it’s too cold, hot, or humid. High humidity could make you tire more quickly. Extreme temperatures can interfere with blood circulation, make breathing difficult, and cause chest pain. Instead, try indoor activities, like mall walking.
4. Drink enough water so you don’t get dehydrated. Follow your doctor's guidelines about how much fluid you can have in a day.
5. Avoid very hot or cold showers or saunas after exercise. Temperature extremes increase the workload on the heart.
6. Don't exercise in hilly areas unless you’ve discussed it with your doctor. If you must walk on steep slopes, slow down when going uphill to avoid working too hard.

If your exercise program has been interrupted for more than a few days (perhaps due to illness, vacation, or bad weather), ease back into it.
New Treatments for Diabetes and Obesity:-
(1)The main treatment for obesity consists of dieting and physical exercise.
(2) Diet programs may produce weight loss over the short term. But maintaining this weight loss is frequently difficult and often requires making exercise and a lower food energy diet a permanent part of a person's lifestyle. All types of low-carbohydrate and low-fat diets appear equally beneficial.
(3) Three medications, Orlistat (Xenical), lorcaserin (Belviq) and a combination of phentermine and topiramate (Qsymia) are currently available . Weight loss with orlistat is modest, an average of 2.9 kg (6.4 lb) at 1 to 4 years. Its use is associated with high rates of gastrointestinal side effects and negative effect on kidney. however, it may increase heart valve Problem.
(4)In India I have used several Herbal Products Drugs like Zerofat-A 1Cap twice daily 1hour before lunch and dinner.Till now I have not got any side effects.
(5) The most effective treatment for obesity is bariatric surgery.[ Surgery for severe obesity is associated with long-term weight loss, improvement in obesity related conditions,[164] and decreased overall mortality. One study found a weight loss of between 14% and 25% (depending on the type of procedure performed) at 10 years
(6)Renin blocking drugs Used for Hypertension like lisinopril, enalapril, perindopril, ramipril, quinapril etc may also be used eventually to treat diabetes and obesity, as well as insulin resistance. In various clinical trials, these drugs are showing positive results when it comes to improving insulin sensitivity and reducing the incidence of type II diabetes.
SUMMERY:-Obesity and diabetes can be prevented By following activity.
*Healthy Weight.
* increase your physical activity.
*Give Vitamin
* High fibre diet
*Low carbohydrate diet
*20-30Minuetes Of Brisk walk or any Activity
*Fast food culture should be avoided.
THANK  YOU

Biography:
DR PREMANIDHI PANDA,M.D(MED),HON PhD IN DIABETES,MRCP,FRCP has completed his M.B.B.S at the age of 24 years from Berhampur University, India and postdoctoral studies,M.D(MED) from UTKALUniversity School of Medicine. He is the director of Prof. Panda DIABETES INSTITUTE,INDIA, a premier DIABETES HOSPITAL CUM RESEARCH CENTRE,INDIA.He has worked in TISCO HOSPITAL,INDIA,BENGHAZI MEDICAL(LIBYA),MEDWIN HOSPITAL With Repute. He has been awarded as “India’s BEST DOCTOR AWARD:-2013(DIABETES)” BY MEDGATE TODAY SURVEY. He Has been Awarded MRCP,FRCP BY ROYAL COLLEGE OF PHYSICIAN AND SURGEON OF AMERICA IN THE YEAR 2011. He has published more than 26 papers in reputed journals and serving as an editorial board member of repute. He has been awarded several National & International Awards for His Contributions.