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Abstract
The growing spread of obesity, type 2 diabetes and cardiovascular diseases necessitates an action to detect and treat the root cause of the problem.
Most type 2 diabetic patients are obese. The mechanisms by which obese people develop type 2 diabetes are not clear yet.
Insulin resistance is a core problem. Fat is discovered to be an endocrine gland that secretes many biologically active substances including inflammatory mediators.
Obesity was found to be associated with a chronic state of low grade inflammation.
Inflammatory and other mediators emerged as possible links between obesity, insulin resistance, atherosclerosis, and other obesity and diabetes complications (Bakhai 2008). Animal (Hotamisligil et al., 1993) and human studies (Alexandraki et al., 2006) supported these ideas when they came with results that support association of adipokines with insulin resistance (Hak et al., 2001), diabetes (Schmidt et al., 1999), endothelial dysfunction (Hess et al., 2009) and thromboembolic risk (Kohler et al., 2002).
Weight loss especially losing visceral fat emerged as a possible prevention and or treatment for obesity related complications including diabetes and cardiovascular diseases.
Studies from lifestyle interventions and bariatric surgeries added more support when they came with evidence that weight loss is associated with health benefits and at the same time changes of adipokines and inflammation mediators (Bastard et al. , 2000) (Nicklas et al., 2004).