Treating obesity to fight type 2 diabetes

The obesity issue is very complex, from the causes and results to the possible methods of treatment. Watch Daniel Kelly, MD, founding scientific director for Sandford-Burnham and director of the Diabetes and Obesity Research Center, explain.

Transcript

00:00

DANIEL KELLY: Obesity, per se, is not necessarily the kind of problem that we as physicians would categorize

00:07

as a disease because it's difficult to show that, other than some of the physical factors, if you will,

00:16

and the reduced mobility and some propensity to musculoskeletal disorders, a clear-cut change in longevity

00:27

actually comes from the fact that it's driving type 2 diabetes largely.

00:40

If you treat a diabetic of, let's say, after a heart attack or even with heart failure, the efficacy of that treatment

00:49

is reduced compared to the non-diabetic. In other words, our standard therapies for heart and vascular disease are not working as well.

00:57

And that is because we do not understand this rather unique form of heart and vascular disease that occurs in the context of diabetes.

01:07

And so it will be very helpful for us-- and we're doing these, and other people are doing these studies-- to understand a little bit more about the genome

01:18

of these individuals. Because it's probably not going to be a single aha moment with a mutation in one gene,

01:25

but there will be variations that come together that probably protect these individuals. And we would-- we you like to look and see,

01:33

if we look at those individuals and compare them to those who develop heart disease with only a modest increase in obesity or diet-- or insulin resistance

01:43

and diabetes rapidly with obesity, that we would compare those. So that might be an opportunity for the genomic approach.

01:52

There are several new medications coming out there just on the horizon that will reduce appetite.

01:59

And so one approach in the future that we should look at are appetite-reducing medications.

02:05

We need also, if you will, a one-two punch for this problem, which would be reducing appetite and increasing peripheral energy

02:14

expenditure. If you will, an exercise in a pill. We are only beginning to understand that changes in--

02:23

I'll just use the term metabolism, but the ability of the body not only to utilize

02:30

the foodstuff that come in as fuel, but also to turn it into building blocks is deranged obviously in obesity and diabetes.

02:39

And some of those derangements, we are learning based in laboratory studies, are capable of driving heart failure and heart disease.

02:47

So there is a really vicious interplay between, first, our propensity in general in the nation

02:54

to develop heart and vascular disease, but when you put the metabolic disturbances upon that, then we have to treat, we believe,

03:01

the metabolic disturbances. [AUDIO LOGO]