‘Diabesity’ and Insulin Resistance: Results from a Study in a Rural Setting of Haryana, India

Introduction: Diabetes mellitus and obesity are closely related in terms of both pathogenesis and pathophysiology. Both metabolic disorders in turn result in vascular complications such as cardiovascular diseases through unknown mechanisms which may be linked to a cluster of risk factors including insulin resistance, hyperglycemia, dyslipidemia, hyperinsulinemia and systemic inflammation. Dyslipidemia, an important component of insulin resistance syndrome, type 2 diabetes mellitus (T2DM) and obesity, is characterized by increased triglycerides, low density lipoprotein-cholesterol and decreased high density lipoprotein-cholesterol. Aims and Objectives: The present study was undertaken to estimate and compare the levels of fasting plasma glucose, serum lipid profile and insulin resistance in type 2 diabetes mellitus patients and non-diabetic subjects with and without obesity. Materials and Methods: A total of 400 subjects comprising 200 T2DM patients (with and without obesity) attending the OPDs and wards of Department of Medicine, M.M Institute of Medical Sciences and Research, Mullana, Ambala and 200 non-diabetic subjects (with obesity and without obesity) from amongst the attendants of the patients and volunteers in the age range of 30-70 years of either sex were selected for the study. Fasting plasma glucose (FPG) and serum lipid profile levels including total cholesterol, triglycerides, LDL-C, HDL-C and VLDL-C were measured while insulin resistance was calculated using homeostasis model assessment method (HOMA). Results: It was observed that fasting plasma glucose levels were significantly higher in non-obese than obese diabetics (p 0.05), although obese individuals were more insulin resistant than non-obese subjects. Conclusion: The subjects with both DM and obesity were significantly more insulin resistant than those suffering from either of two diseases. It is imperative that persons with co-existent DM and obesity should be regularly monitored for their blood lipid levels in order to reduce the associated cardiovascular disease risk.