Rates of childhood and adolescent obesity are increasing worldwide, and young people with overweight or obesity are more likely to have obesity in adulthood. Childhood obesity has a more severe life-long impact than adult-onset obesity, and children with severe obesity are at higher risk for hypertension, type 2 diabetes, metabolic syndrome, non-alcoholic fatty liver disease and cardiovascular disease than those without. Early assessment, diagnosis and intervention is important to improve long-term outcomes for young people with obesity.
Individuals living with type 2 diabetes (T2DM) and high cardiovascular (CV) risk are more susceptible to chronic kidney disease (CKD) and kidney failure. With approximately 20–50% of adults with T2DM ultimately developing CKD, an important goal of therapy is to reduce or prevent the progression of this complication.
The fields of obesity and type 2 diabetes (T2D) are rapidly evolving, and 2022 has seen a number of exciting advances that have the potential to dramatically improve patient health outcomes and quality of life.
Conventional dietary interventions are based on the idea that a calorie is a calorie, regardless of the time of day it is ingested. However, accumulating evidence suggests that the timing of food intake might predict weight loss effectiveness. Energy homeostasis has been linked to circadian rhythm at a physiological and behavioural level, but the way calories are used and the impact of energy expenditure on weight-related hormones throughout the day is not well defined. Eating at the ‘ideal’ time of day might help to improve metabolic health and body weight maintenance.
Loneliness is a distressing emotion that occurs when there is a perceived imbalance between one’s social needs and the quality of one’s social relationships. While loneliness is not diagnosed as a mental health condition, it is complex and unique to each person. Previous studies suggest that depression and insomnia are risk factors for type 2 diabetes (T2DM), mediated via the body’s physiological stress response. Loneliness can lead to depression and can also contribute to sleep disorders, but the link between loneliness and risk for T2DM is poorly understood.
Effective weight management is critical to reducing the health burdens associated with obesity. Evidence suggests that weight loss of 5–10% is associated with improvements in hypertension, dyslipidaemia and hyperglycaemia, and reduced symptoms of non-alcoholic fatty liver disease and polycystic ovary syndrome. Greater weight loss is associated with greater health benefits with weight loss of >15% needed for remission of type 2 diabetes.
Current estimates indicate that type 2 diabetes (T2DM) now affects more than 500 million people worldwide. Improving glycaemic control in people with T2DM is critical to improving quality of life and preventing or delaying progression to micro- and macrovascular complications. For people living with diabetes, cardiovascular risk is estimated to be 2–5 times higher than those without diabetes. Microvascular complications such as retinopathy, nephropathy, and neuropathy are also common among people with T2DM, especially those with a disease duration of >10 years.
Obesity is a chronic disease that is associated with a sixfold increased risk of developing type 2 diabetes mellitus (T2DM). A 5% reduction in weight can improve glycaemic control, with greater amounts of weight loss leading to further improvements in cardiometabolic risk factors and complications of obesity. While the health benefits of sustained weight reduction are clear, achieving long-term weight loss with lifestyle interventions alone is challenging due to biological processes that defend against an individual’s highest weight. Pharmacotherapies approved for the treatment of obesity, such as some glucagon-like peptide 1 receptor agonists (GLP-1 RAs), can help people achieve long-term weight loss when combined with lifestyle interventions by targeting the biological processes of appetite regulation.
Diabetic neuropathy is the most common chronic complication of diabetes, affecting around half of all people living with diabetes during their lifetime. Peripheral neuropathy is a subset of nerve damage that causes pain, numbness, or weakness in the extremities, such as hands, feet, and arms. Pain associated with diabetic peripheral neuropathy is estimated to affect around a quarter of people living with diabetes throughout their lifetime, is often debilitating and is associated with increased risk for sleep and mood disorders. Managing neuropathy-associated pain should, therefore, be considered a priority in order to improve quality of life for people living with diabetes.
Sleep deprivation is widely recognized as a potential contributor to overweight and obesity at all ages, but sleep inadequacy is particularly prevalent among the younger population. According to the Centers for Disease Control and Prevention in the US, the recommend hours of sleep per night are 10 to 13 hours for preschoolers aged 3–5 years, 9 to 12 hours for children aged 6–12 years, and 8 to 10 hours for teenagers aged 13–18 years. A growing body of research shows that insufficient sleep at a younger age may set the stage for insulin resistance, excess weight, irregular blood lipid levels and hypertension in adulthood.