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Re: Keeping ‘diabesity’ in check – the onus is on clinicians

Dear Editor,

The finding that most patients with type 2 diabetes are either obese or overweight (1) is not surprising, but is nevertheless worrisome. Recently published data (2) show that there has been a steady increase in the prevalence of type 2 diabetes in England and Wales between 1994 and 2001. This study which evaluated a large number of individuals in several primary care centres also found that prevalence of obesity in the population with diabetes was rising. Importantly, this happened despite significant therapeutic advancements. Obesity has been directly linked to the metabolic syndrome, type 2 diabetes and cardiovascular risk and this underscores the urgent need to tackle this problem, more aggressively in people.

This begs the question, do clinicians provide adequate information to patients on weight reduction and physical activity during consultations and in-hospital management? It can be argued that physicians compared to other members of a multidisciplinary team, tend to have a greater impact on patients. The National Institute for Health and Clinical Excellence is due to publish formal guidance on prevention and treatment of obesity in November this year (3). One has to wait and see whether it will improve practices and alleviate the growing burden of ‘diabesity’ in the community.

References

1. C Daousi, I F Casson, G V Gill, I A MacFarlane, J P H Wilding, and J H Pinkney. Prevalence of obesity in type 2 diabetes in secondary care: association with cardiovascular risk factors. Postgrad Med J 2006; 82: 280 -284.

2. Lusignan S, Sismanidis C, Carey IM, DeWilde S, Richards N, Cook DG. Trends in the prevalence and management of diagnosed type 2 diabetes 1994- 2001 in England and Wales. BMC Fam Pract 2005 Mar 22;6(1):13.

3. http://www.nice.org.uk/page.aspx?o=obesity#keydocs