The Role of Cortisol and Abdominal Obesity in the Epidemic of Type 2 Diabetes

Tracey Liebman, University of Pennsylvania

Full Paper: http://www.kon.org/urc/v9/liebman.html

Abstract A rising number of individuals in the US are overweight and obese; although the morbidity and mortality rates for countless diseases have been reduced due to advances in medical research and high standard of living, the rate of type 2 diabetes mellitus increases. The culture of our affluent nation has promoted the consumption of high caloric, processed food along with physical inactivity. In the attempt to control the rise of type 2 diabetes, new treatments such as these 11β-HSD1 inhibitors and others that focus on mechanisms relating to cortisol regulation may have favorable results. Diabetes prevalence is increasing because the population is aging, people are progressively more overweight and physically inactive, and minority groups that seem more susceptible to diabetes make up an increasing percentage of the US population. Cortisol may play an important role; it is possible that even small increases in cortisol, within the range of normal, may have a detrimental influence by worsening diabetes and increasing complications. This paper is a review of the role of cortisol and abdominal obesity in the epidemic of type 2 Diabetes. As diabetes continues to grow in prevalence, the problems will become even more extensive and debilitating for society if optimal preventative measures are not taken. Future efforts in this related struggle against both obesity and type 2 diabetes should encompass a strong focus on cortisol so such prevention and treatment can successfully advance. 

Diabesity: A Connection between Obesity and Diabetes

A rising number of individuals in the US are overweight and obese; although the morbidity and mortality rates for countless diseases have been reduced due to advances in medical research and high standard of living, the rate of type 2 diabetes mellitus only increases. The culture of our affluent nation has promoted the consumption of high caloric, processed food along with physical inactivity. According to the US National Commission on Diabetes, the likelihood of acquiring type 2 diabetes is 2-fold for mildly obese individuals, 5-fold for moderately obese individuals, and 10-fold for the severely obese individuals (Pi-Sunyer, 2007). The disease is costly, difficult to treat, and reduces life expectancy by 8 to 10 years (Astrup, 2000). The many complex mechanisms leading to diabetes are not yet fully understood, but the term diabesity has been suggested (Abate, 2003). Abdominal obesity has been strongly correlated with insulin resistance and type 2 diabetes, and cortisol may be involved (Franco, 2001).

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