The journal for healthcare professionals managing people with coexisting diabetes and obesity.

Type 2 diabetes is considered by diabetes physicians as a complex and heterogeneous disease with a poorly understood aetiology, apart from the fact that there is a strong genetic propensity that becomes overt when exposed to a typical Western lifestyle. Our clinical targets are now moving from controlling the disease to preventing it. Do we need to await more research on the aetiology and pathophysiology before establishing a preventive strategy? No, the pathophysiology may be poorly understood, but there is now solid evidence that type 2 diabetes is a disease of fatness. New, controlled, clinical trials show that as little as 5% weight loss is sufficient to prevent most obese subjects with impaired glucose tolerance developing type 2 diabetes. Since type 2 diabetes is obesity dependent, and obesity is the main aetiogical cause of type 2 diabetes, we propose the term ‘diabesity’ should be adopted.

Type 2 diabetes is characterised by resistance to insulin's action and impaired insulin production by the pancreas, either of which may predominate. It is the most common form of diabetes accounting for more than 85% of persons with diabetes in Australia. It has a strong genetic (familial) propensity which is unmasked by lifestyle factors such as obesity (hence the term “diabesity”) and lack of exercise. In most instances, the molecular or metabolic causation is not yet known.