Youth·Obesity·Diabetes

Youth·Obesity·Diabetes

Du Guoli1,2, Jiang Sheng1, Shariyan Tursunmamat1

1. Diabetes Committee of Xinjiang Medical Association, The First Affiliated Hospital of Xinjiang Medical University

2. Xinjiang Bayingol Prefecture People's Hospital

Youth is the best time of life, a period when a person's life is in bud, full of vitality and vigor. It means progress, means rise, and contains unknowns with great hope. However, at this age when we need to struggle, be enterprising and pursue our dreams, many young people suffer from obesity and diabetes, and endure the double torture of physical and psychological obesity and diabetes. What causes more and more obesity and diabetes among young people, and how to help them are the topics we explore.

In modern life, due to excessive intake of nutrition, unbalanced nutrition, improper proportion of three meals, and greatly reduced exercise, more and more people are obese, especially among teenagers, and the incidence of obesity and diabetes is increasing. The diagnosis of obesity is mainly based on excessive accumulation and (or) abnormal distribution of body fat: 1. Body mass index (BMI) is a commonly used measurement indicator. BMI = weight (kg) / height (m) 2 The diagnostic criteria for obesity and overweight in the Asia-Pacific region are: 24kg/m2≤BMI＜28kg/m2 is overweight, and BMI≥28kg/m2 is obesity. 2. The distribution characteristics of body fat can be measured by waist circumference. Waist circumference is the radial distance between the midpoint between the costal margin of the midaxillary line and the anterior superior spine. Waist circumference of men ≥90cm (women ≥85cm) (China Diabetes Society) can be regarded as central obesity. Studies have shown that obese people are more likely to develop insulin resistance and diabetes. The latest diagnostic criteria for diabetes are that the concentration of glucose in the blood is too high under different specific circumstances, reaching the corresponding diagnostic indicators. Diabetes can be diagnosed if the patient has typical diabetic symptoms of polydipsia, polyphagia, polyuria, and weight loss, plus a random blood sugar level ≥11.1mmol/L, or a fasting blood sugar level ≥7.0mmol/L, or a blood sugar level ≥11.1mmol/L in a glucose tolerance test (generally 75 grams of anhydrous glucose is taken orally and the concentration of glucose in the blood is tested 120 minutes later), or a glycosylated hemoglobin level ≥6.5%.

Adolescent obesity and diabetes are one of the major health issues facing the world today. Adolescence is the peak period of individual growth and development, and is the second accelerated development period after infancy. Rapid physical growth is the main feature of this period, and children at this stage will undergo great changes both physically and mentally. With the development of social economy, parents pay more attention to their children's nutrition, but some parents' excessive "supplements" can cause their children to become obese. Obesity is one of the main risk factors for diabetes. Among obese adolescents, the risk of insulin resistance and hyperglycemia increases, which may lead to the occurrence of diabetes. Obesity can lead to increased resistance to insulin in the body, i.e. insulin resistance. Insulin is a hormone that regulates blood sugar levels, which promotes blood sugar to enter cells for energy use. However, obesity leads to increased accumulation of adipose tissue, and the fatty acids and hormones released by adipocytes interfere with the normal action of insulin, resulting in reduced cellular responsiveness to insulin. Long-term exposure to high insulin levels may gradually cause pancreatic B cells to lose their normal function and reduce insulin secretion. This further exacerbates the difficulty of insulin resistance and blood sugar control, and increases the risk of diabetes. In the obese state, adipose tissue releases some inflammatory factors, which are involved in the occurrence of insulin resistance and inflammatory response. This low-grade chronic inflammatory state may accelerate the development of diabetes. Unhealthy eating habits and lack of physical activity are one of the main causes of obesity and diabetes. Excessive intake of high-sugar, high-fat and high-calorie foods, coupled with lack of physical exercise, will lead to excess energy intake and weight gain, promoting the development of obesity and diabetes.

As for how to avoid obesity and diabetes, we first need to eat healthy and balanced foods. Increase the intake of vegetables, fruits, whole grains and proteins, and limit the consumption of high-sugar, high-fat and processed foods. Develop healthy eating habits, including eating on time, eating in moderation and avoiding overeating. Eat portions and avoid overeating. Use small plates or bowls to control food intake and avoid taking in too many calories at one time.

Secondly, regular exercise is also very necessary. Carry out regular physical exercise and physical activities, and do at least 60 minutes of moderate-intensity aerobic exercise every day, such as brisk walking, running, cycling, etc. At the same time, add strength training to enhance muscle strength and strengthen bone health. Reduce sedentary time, get up and move every hour, do stretching exercises or simple physical activities. Of course, you also need to avoid staying up late and irregular work and rest time. Provide popular science education on healthy diet, exercise and obesity-related diabetes, increase knowledge and awareness of health, and raise social attention and awareness of obesity and diabetes issues through publicity activities, health education courses and community activities. Regular physical examinations, including measuring height, weight and blood pressure, and conducting related tests such as blood sugar and blood lipids, as well as assessing the risk of diabetes and obesity.

If blood sugar is already higher than normal and diet and exercise are ineffective, we should choose to seek medical attention in time, make a clear diagnosis, take regular oral medication under the guidance of an endocrinologist, monitor blood sugar, and adjust the medication plan in time. If obesity is clearly diagnosed and there is a trend of further weight gain, diet and exercise control is ineffective, and it has already caused a certain impact on health, it is also necessary to seek medical attention in time. Nowadays, there are newer subcutaneous injection drugs such as glucagon-like peptide-1 receptor agonists (GLP-1RA). There are also real cases of weight loss combined with GLP-1RA in clinical practice. A 30-year-old young woman gained weight, which has affected the body's metabolic data and caused abnormalities. After using GLP-1RA for one year, her weight dropped from 145 kg to 127.45 kg. After combined weight loss surgery, GLP-1RA continued to be used after surgery. One month after surgery, her weight dropped from 127.45 kg to 112.45 kg. This shows that GLP-1RA has many advantages in weight loss, and patients with severe obesity can benefit from weight loss surgery. The combined use of GLP-1RA before weight loss surgery can effectively reduce the weight of severely obese patients, reduce the complications that may be caused by weight loss surgery in extremely obese patients, and improve the success rate of weight loss surgery. In the process of using GLP-1RA to lose weight, metabolic indicators such as blood sugar and blood lipids return to normal.

Therefore, obesity and diabetes need to be paid attention to, especially the occurrence of obesity and diabetes in adolescents and young people needs to be taken more seriously. It may have long-term effects on the health and psychology of adolescents. Pay attention to adolescents' eating habits, physical activity levels and weight changes, and provide support and guidance. We need to create a healthy environment, provide a nutritionally balanced diet, encourage moderate physical exercise, and set health goals. In addition, understand the risks and health problems of adolescent obesity and diabetes, collaborate with doctors, and develop personalized management plans to ensure the healthy development of adolescents. Active intervention is crucial to help adolescents prevent and cope with adolescent obesity and diabetes, and helps to establish healthy living habits.

References:

[1] Obesity Prevention and Control Branch of Chinese Nutrition Society, Clinical Nutrition Branch of Chinese Nutrition Society, Behavioral Health Branch of Chinese Preventive Medicine Association, etc. Expert consensus on obesity prevention and control in Chinese residents[J]. Chinese Journal of Epidemiology, 2022, 43(5):18.

[2] Chinese Diabetes Society. Guidelines for the prevention and treatment of type 2 diabetes in China (2020 edition)[J]. Chinese Journal of Diabetes, 2021, 13(4): 315-409.

[3] Li Jing. You should know the dangers of obesity and diabetes in adolescents[J]. Adolescent Health, 2023, 21(9): 50-51.