Abstract
For several years obesity and type2 diabetes have been increasingly summarized under the name "diabesity". This is due to the fact that in most cases obesity precedes diabetes and is the most important risk factor for the worldwide increase of type2 diabetes. The body mass index (BMI) is avery crude measure of body fatness in individuals. Even normal weight persons can have too much body fat in cases of alack of muscle mass (sarcopenia), which is why additional measurements of waist circumference and body fatness, e. g. bioimpedance analysis (BIA), are recommended. Lifestyle management including nutrition modification and increase in physical activity are important measures for the prevention and treatment of diabetes. Regarding the treatment of type2 diabetes, body weight is increasingly used as a secondary target parameter. The choice of anti-diabetic treatment and also concomitant treatment is increasingly influenced by body weight. The significance of anti-obesity medications in the treatment of type2 diabetes will have to be clarified by future studies with body weight as the primary endpoint. Bariatric surgery is at present indicated with aBMI >35 kg/m2 with concomitant risk factors, such as diabetes and can lead at least to partial diabetes remission but has to be incorporated into an appropriatelifelong care concept.
Highlights
„Diabesity“ – Adipositas und Typ-2-Diabetes (Update 2019) S71 leitlinien für die praxis portant measures for the prevention and treatment of diabetes
Summary For several years obesity and type 2 diabetes have been increasingly summarized under the name “diabesity”
This is due to the fact that in most cases obesity precedes diabetes and is the most important risk factor for the worldwide increase of type 2 diabetes
Summary
Dass jeder BMI mit einem unterschiedlichen Körperfettanteil verbunden sein kann. Zwar weisen fast 100 % der Personen mit einem BMI >30 kg/m2 einen hohen Fettanteil auf, aber auch immerhin noch etwa ein Drittel der Normalgewichtigen [11]. Dies ist auf den heute häufigen Verlust der Muskelmasse und der Muskelkraft mit zunehmendem Alter oder Mangel an Muskelmasse (Sarkopenie) zurückzuführen, die eine ungünstige Fett-Muskel-Relation auch bei Normal- oder Übergewicht bedeutet [12,13,14]. Als Grenzwerte für den Bauchumfang gelten für eine kaukasische Bevölkerung 88 cm für Frauen und 102 cm für Männer, wobei diese Werte jedoch bei älteren Personen (geringere Körpergröße, Kyphose, Skoliose) nicht anwendbar sind. B. Asiaten) bei gleichem BMI eine größere Fettmasse aufweisen, werden für diese Kollektive andere Grenzwerte diskutiert [15]. Ein Screening auf Sarkopenie mittels eines Fragebogens SARCF kann helfen, eine Sarkopenie frühzeitig zu erkennen [18, 19]
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