Diabetes - Obesity - Sugar

Global diabetes prevalence has more than doubled over the last three decades. Nearly 1 in 10 adults worldwide are now affected by diabetes.

In the past, it was thought that type 2 diabetes are due to “metabolic syndrome” – the cluster of metabolic perturbations that includes dyslipidemia, hypertension, and insulin resistance. And obesity is the strongest risk factor for type 2 diabetes.

However, it was found that about 20% of obese individuals appear to have normal insulin regulation and normal metabolic indices (no indication of diabetes), while up to 40% of normal weight people in some populations manifest aspects of the “metabolic syndrome”.

In the meantime, several countries with high diabetes prevalence rates have low obesity rates, and vice versa. High diabetes yet low obesity prevalence are also observed in countries with different ethnic compositions.

Trends in diabetes and obesity are dyssynchronous within some nations. For example, while Sri Lanka’s diabetes prevalence rate rose from 3% in the year 2000 to 11% in 2010, its obesity rate remained at 0.1% during that time period. Conversely, diabetes prevalence in New Zealand declined from 8% in 2000 to 5% in 2010 while obesity rates in the country rose from 23% to 34% during that decade.

And so it appears that there is no strong direct relationship between diabetes and obesity. 

PLOS ONE, an international online publication, published a study, found that every 150 kcal/person/day increase in sugar availability (about one can of soda/day) was associated with increased diabetes prevalence by 1.1%.

The impact of sugar on diabetes was independent of sedentary behavior and alcohol use and the effect was modified but not confounded by obesity or overweight. At the same time, the duration and degree of sugar exposure correlated significantly with diabetes prevalence in a dose-dependent manner while declines in sugar exposure correlated with significant subsequent declines in diabetes rates independently of other socioeconomic, dietary and obesity prevalence changes. Differences in sugar availability statistically explain variations in diabetes prevalence rates at a population level that are not explained by physical activity, overweight or obesity.

The method they used is the econometric models of repeated cross-sectional data on diabetes and nutritional components of food from 175 countries.