Treating obesity to fight type 2 diabetes
The obesity issue is very complex, from the causes and results to the possible methods of treatment. Watch Daniel Kelly, MD, founding scientific director for Sandford-Burnham and director of the Diabetes and Obesity Research Center, explain.
DANIEL KELLY: Obesity, per se, is not necessarily the kind of problem that we as physicians would categorize
as a disease because it's difficult to show that, other than some of the physical factors, if you will,
and the reduced mobility and some propensity to musculoskeletal disorders, a clear-cut change in longevity
actually comes from the fact that it's driving type 2 diabetes largely.
If you treat a diabetic of, let's say, after a heart attack or even with heart failure, the efficacy of that treatment
is reduced compared to the non-diabetic. In other words, our standard therapies for heart and vascular disease are not working as well.
And that is because we do not understand this rather unique form of heart and vascular disease that occurs in the context of diabetes.
And so it will be very helpful for us-- and we're doing these, and other people are doing these studies-- to understand a little bit more about the genome
of these individuals. Because it's probably not going to be a single aha moment with a mutation in one gene,
but there will be variations that come together that probably protect these individuals. And we would-- we you like to look and see,
if we look at those individuals and compare them to those who develop heart disease with only a modest increase in obesity or diet-- or insulin resistance
and diabetes rapidly with obesity, that we would compare those. So that might be an opportunity for the genomic approach.
There are several new medications coming out there just on the horizon that will reduce appetite.
And so one approach in the future that we should look at are appetite-reducing medications.
We need also, if you will, a one-two punch for this problem, which would be reducing appetite and increasing peripheral energy
expenditure. If you will, an exercise in a pill. We are only beginning to understand that changes in--
I'll just use the term metabolism, but the ability of the body not only to utilize
the foodstuff that come in as fuel, but also to turn it into building blocks is deranged obviously in obesity and diabetes.
And some of those derangements, we are learning based in laboratory studies, are capable of driving heart failure and heart disease.
So there is a really vicious interplay between, first, our propensity in general in the nation
to develop heart and vascular disease, but when you put the metabolic disturbances upon that, then we have to treat, we believe,
the metabolic disturbances. [AUDIO LOGO]
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