Epidemiologische und pathophysiologische Beziehungen zwischen Übergewicht, Adipositas und Typ-2-Diabetes

Overweight, abdominal fat distribution and obesity increase the risk of developing type 2 diabetes. There is a strong epidemiologic association between higher body weight and type 2 diabetes that has been consistently shown for men and women in different age groups and regions. The globally increasing prevalence of type 2 diabetes is mainly driven by the obesity pandemic over the past 30 years. Consequently, targeted weight reduction is an important intervention to prevent or delay type 2 diabetes and can lead to type 2 diabetes remission after manifestation of the disease. The extent of weight reduction, which can be achieved through dietary changes, increased physical activity, behavioral changes, drug or surgical treatment strategies, is associated with a higher likelihood to achieve type 2 diabetes remission. People living with obesity and type 2 diabetes had highest diabetes remission rates after a >10–15% weight loss both through diet or metabolic surgery interventions. The epidemiologic association between overweight, obesity and type 2 diabetes could be explained by common genetic predisposition, shared social and environmental factors, but also pathophysiologic mechanisms. Obesity-related insulin resistance, abdominal fat distribution and adipose tissue dysfunction with the secretion of a proinflammatory and diabetogenic molecule profile promote the manifestation of type 2 diabetes.