Obesity and Type 1 Diabetes
First published in 2008 - Last edited in May 2022 by Luka Tunjic. © All rights reserved.
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Does Obesity Protect against Type 1 Diabetes????
The Discovery of Type 1 Diabetes
The French physician Étienne Lancereaux (1829 –1910) is generally credited with making the distinction between fat and thin diabetes: diabete gras (big) and diabete maigre (lean)”
The distinction between the two forms of diabetes was indeed stark in the pre-insulin era. Most children and some adults died of diabetes within months, whereas overweight older patients often survived for years. When insulin became available, those in the first category no longer wasted away, whereas those in the second continued to get by on diet alone.
Source: American Diabetes Association http://diabetes.diabetesjournals.org/content/50/2/217.full#ref-5
Side note: If all people with Type 1 diabetes always stay obesity free it will be a little bit easier to explain why obesity provides protection from Type 1 diabetes, but the fact is that many of them sometime after their diagnosis of Type 1 diabetes start to gain weight and a relatively small number of them end up being technically obese.
There are differences between overweight -obese people with Type 1 diabetes and overweight-obese people without Type 1 diabetes. The most visible differences are in their body fat percentages, body weight distribution and in the shape of their musculoskeletal system.
More about the differences I will intend to talk about later, but for now it is important to validate the initial observation: Obesity, particularly severe obesity, somehow provides protection against the development of Type 1 diabetes. (At this stage of the discussion it needs to bear in mind that: Obesity protects against Type 1 diabetes but it doesn’t cure Type 1 diabetes.)
One study that makes a connection between obesity and type 1 diabetes is published in the October issue of the American Diabetes Association journal Diabetes Care. I couldn’t find that study on the American Diabetes Association website, but the article regarding that study was published online on the WebMD under the title “Obesity Linked to Type 1 Diabetes”.
In a hypothesis first made public two years ago, U.K. researcher Terry Wilkin, MD, and colleagues suggested that type 1 diabetes and type 2 diabetes are "one and the same disorder of insulin resistance set against different genetic backgrounds."
The obesity epidemic is widely blamed for a startling rise in the incidence of type 2 diabetes among children. Intriguing new research suggests it is also to blame for a similar increase in type 1 diabetes.
Source: WebMD http://diabetes.webmd.com/news/20030926/obesity-linked-to-type-1-diabetes
If you read the article “Obesity Linked to Type 1 Diabetes” you will notice they found only a connection between overweight and Type 1 Diabetes. The misinterpretation of the original research and the title of the article published on the WebMD site is misleading. If you take a look at this article you will notice that researchers are not talking about the connection between obesity and type 1 diabetes, but they are talking about the connection between overweight and type 1 diabetes.
Side note: It is a little bit odd that researchers jump from a higher body index (overweight) to obesity. Probably it is not comfortable for anyone to say that being overweight independently increases the risk of later type 1 diabetes and that obesity doesn’t.
Association between childhood obesity and subsequent Type 1 diabetes: a systematic review and meta-analysis.
Of these nine studies, seven reported a significant association between childhood obesity, BMI or %weight-for-height and increased risk for Type 1 diabetes.
.....in those studies, age at obesity assessment varied from age 1 to 12 years.
Sources: Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. http://www.ncbi.nlm.nih.gov/pubmed/21166841
1. There is no report that one child was obese at the time of diagnosis.
2. There is no report that any adult was severely obese or at the time of type 1 diabetes diagnosis.
At this point of the discussion, it can be concluded that obesity somehow protects against the development of type 1 Diabetes.
Also, it needs to bear in mind that many people with type 1 diabetes after some time of diagnosis become overweight and some of them become obese. If obesity protects against type 1 diabetes than when people become obese should be cured from type one diabetes when they become obese, but there is no one case that anyone was cured by becoming obese. Instead, they have just one more burden: they are affected with obesity and with type 1 diabetes.
Not only does obesity somehow protect against development of Type 1 diabetes, but it ( technical obesity) has a protective role against death in people with Type 1 diabetes. - Side note: Mind the difference between obese and technically obese.
Even people who were technically obese were less likely to die if they had type 1 diabetes, the team at the University of Pittsburgh found. Weight gain no big deal in type 1 diabetes: study - Reuters
All studies about the relations between Type 1 diabetes and obesity are a little bit confusing by mixing the terms technically obese and obesity. Obesity is understood as excessive body fat mass. Technically obese means only body weight. People without any excessive body fat mass can be classified as technically obese because they are just heavier than average.
According to the government standard, Tom Cruise, Sylvester Stallone, and Mel Gibson are technically obese.
At this point it can be concluded that obesity and severe obesity somehow have a protective role against the development of Type 1 diabetes, and that obesity doesn’t have a curative role in Type 1 diabetes.
It is not to be expected that anyone will come to the idea that promoting obesity as a prevention against type 1 diabetes because childhood obesity can lead to the development of many serious medical problems, like type 2 diabetes, atherosclerosis, hypertension, respiratory problems etc. but the fact that obesity somehow protects against the development of Type 1 diabetes will be an important step in understanding what causes, how to prevent and what will cure Type 1 diabetes.
Obesity is not what protects us from Type 1 diabetes.
Something else that goes along with obesity is what protects against Type 1 diabetes.
The first step to understand what protects us from developing Type 1 diabetes is to analyse and compare the postural and musculoskeletal characteristics of obese, overweight and normal weight people.
Upon a closer observation it can be noticed that:
1. All underweight people share a few postural and musculoskeletal characteristics.
2. All severely underweight people have almost identical postural and musculoskeletal characteristics.
3. All normal weight people share a few postural and musculoskeletal characteristics.
4. All overweight and obese people share a few postural and musculoskeletal characteristics.
5. All severely obese people have almost identical postural and musculoskeletal characteristics.
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