Friday, November 27

Relationship between diabetes, obesity and Covid-19



Obesity, also called 21st century epidemic, currently affects four out of ten adults and its consequences are associated with other diseases, called comorbidities, as severe as type 2 diabetes, serious diseases such as dyslipidemia, arterial hypertension, coronary disease, stroke, Sleep Apnea Syndrome, among others, which condition a cardiovascular risk very high, multiplying by six the risk of dying from cardiovascular disease.

The doctor Carlos Sala, head of the Obesity and Nutrition Unit of the Quirónsalud Alicante Medical Center, highlights that «there are different types and stages of obesity, for this reason the Unit carries out a study and assessment of pathologies partners to decide which treatment is best suited to their circumstances. In addition, it has a continuous monitoring from all the specialists involved in treatment to help you achieve your goal.

What Causes Diabetes?

The origin of the type 2 diabetes, the most common of diabetes, is found in multiple factors, the most important being excess weight, physical inactivity and poor diet. Other determining causes are family history of diabetes, past history of diabetes gestational and the age.

Diabetes associated with obesity can multiply the probability of dying by six times one cardiovascular disease, as stated by Dr. Carlos Sala.

It is a disease that habitually no symptoms in the early stages, “Which causes that, on many occasions, diabetes is diagnosed years later, when it has already affected the body and led to complications“, Explain Dr. Guillermo Negueruela, specialist in endocrinology of the Quirónsalud Torrevieja Hospital “Well, if the glucose levels diseases caused by diabetes remain elevated ”.

80% of patients with diabetes die of cardiovascular disease and in our environment it is the leading cause of blindness in adults, of chronic kidney failure requiring dialysis, as well as non-traumatic amputation of the lower limbs. “All of this is avoidable if a diagnosis is made in early stages and an adequate treatment is carried out, which includes not only drugs but also changes in lifestyle, with a healthy Mediterranean diet and increasing physical activity ”, says the specialist.

Diabetes Treatment: Metabolic Surgery

“The metabolic surgery It is currently the technique most recommended by specialists thanks to its proven safety and efficacy when it comes to combating overweight and the diseases it causes, such as type 2 diabetes, hypertension, or dyslipidemia, disorders that can reduce the life of the patient by up to 10 years “, as reported by the doctor Carlos Sala, head of the Obesity Unit Quirónsalud Valencia and Alicante, a center where you can request a first appointment to evaluate your case in a personalized way.

Diabetes associated with obesity can multiply by six the probability of dying from cardiovascular disease


For whom is diabetes surgery indicated?

These types of techniques are especially indicated in the treatment of patients with a body mass index greater than 35 or even if it is lower but causes serious associated diseases, such as diabetes with poor metabolic control, high blood pressure, dyslipidaemia or obstructive sleep apnea syndrome.

However, “due to the global epidemic of diabetes and obesity, what is beginning to be called diabesity, for a decade we have been directing interventions towards the resolution of type 2 diabetes, even in patients with grade I overweight or obesity who are not yet morbidly obese but who suffer from type 2 diabetes ”, clarifies Dr. Carlos Sala.

Benefits of metabolic surgery

Regarding the benefits of this intervention, “80% of diabetics stop being so, since the disease remits. The remaining 20% ​​improve substantially, in addition to achieving a greater than 70% loss of excess weight, even reaching the ideal weight if the patient incorporates healthy lifestyle habits, such as physical exercise and a healthy and balanced diet. This results in a average increase in the life span of the obese in ten years, coupled with a better quality of life. In short, “they live longer and better,” explains the specialist.

This method offers highly satisfactory results in patients suffering from type 2 diabetes, allowing them to completely abandon your medication, and prevents the appearance of any type of associated disease.

Despite its benefits, only 5% of obese Spaniards undergo this interventionEither due to lack of information or access to these specialized units, for which Dr. Sala advocates a greater knowledge of the technique and its advantages among primary care specialists.

Relationship between obesity and covid-19

In Spain, more than half of the population (53%) is overweight (a figure that will reach 80% in 2030 if we do not remedy it), and almost a quarter suffer from obesity. In the Valencian community the data is somewhat worse, with a prevalence of 68% overweight, and 20% obesity.

Metabolic surgery makes 80% of diabetics stop being so


Studies carried out in China, as well as in the USA and France, in addition to the clinical experience in our hospitals, have shown that age over 65 years, obesity and hypertension are the three factors of risk for more severe pneumonia by SARS-COV-2, with admission to the ICU, mechanical ventilation and risk of death. This fatal association with obesity is even worse in patients who associate hepatic steatosis (fatty infiltration of the liver) and metabolic syndrome.

Together with diabetes and chronic respiratory disease they affect 90% of patients who are hospitalized. In fact, 65% of patients admitted to ICUs are obese. This relationship became suspicious when the mortality rate was double in New Orleans (high prevalence of obesity) compared to patients in New York.

Why does the body with excess fat respond worse to Covid-19?

Obese patients respond worse to Covid-19 not only due to excess fat, but also due to the large number of diseases associated with it. Obese patients have altered ventilatory mechanics, with lower lung capacity, worse gas exchange in alveoli and one weaker respiratory muscles; which makes it even more difficult to adapt to masks in the event of admission to the ICU. Both obesity and Covid-19 increase the risk of thromboembolism, multiplying the risk, ”explains Dr. Sala.

65% of patients admitted to ICUs are obese


Furthermore, obese patients suffer from chronic inflammatory state which enhances the inflammatory over-response characteristic of infection, called cytokine storm, causing the most lung damage. It is also postulated that fatty tissue would act as a reservoir for the virus, since adipocytes also express the ACE-2 receptor (virus entry gate) like lung cells, so the obese would be infective longer and it would take longer for the PCR tests to become negative.

“It is it is essential to recover healthy habits that we have lost during confinement, both due to diet and sedentary lifestyle, or adopt them in case we previously did not have a healthy life. Normalize the diet, returning to the fresh food as seasonal vegetables, the frequent exercise, and an orderly active life is desirable ”, recommends the specialist.

The most successful way to lose weight is to adopt healthy habits, either through dietary education and psychological intervention in case of overweight, or with the bariatric surgery support in cases of obesity since, in addition to losing excess weight and regaining self-esteem, comorbidities are corrected (diabetes, hypertension, dyslipidemia, sleep apnea, fatty liver, arthropathy, etc.) that worsen quality and reduce life expectancy.

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