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THURSDAY, SEPTEMBER 8, 2016
The Rockaway Times
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HAPPENING AT BUNGALOW
FIRST OF ALL,
THANK YOU
By Peter Galvin, MD
Ask
the
DOC
DIABETES
By Peter Galvin, MD
Diabetes is associated with
multiple complications in-
cluding retinopathy, as one
of my previous articles dis-
cussed. The retina is located on
the back of the eye globe and
it is where the rods and cones
are located. A healthy retina
is essential for good vision. In
diabetic retinopathy small ret-
inal hemorrhages occur which
interfere with the retina’s abil-
ity to convert light images to
nerve impulses, which go to
the brain and are interpreted
to create vision. Good diabetic
control can lessen the chanc-
es of developing retinopathy
(but cannot totally eliminate
the possibility). Poor diabetic
control can almost ensure the
development of retinopathy.
Obesity, as measured by BMI,
is associated with a higher risk
of developing diabetes as well
as it is associated with poor
diabetic control. But obesity
has never been firmly linked to
a higher risk of a diabetic de-
veloping diabetic retinopathy
(DR).
There are racial and eth-
nic differences in the conse-
quences of diabetes. Several
studies have found that Asian
individuals have a higher risk
of developing hypertension,
diabetes and heart disease
than Europeans at the same
BMI. Recently, the Wisconsin
School of Medicine published
a study, done in Singapore,
which looked at the relation-
ship between obesity and the
development of DR in Asians
with Type II diabetes. They
also looked at body fat dis-
tribution using the waist/hip
ratio (WHR). What they found
was rather surprising.
The results indicated that
obesity, as measured by BMI,
did not in and of itself corre-
late with an increased inci-
dence of DR. However those
with abdominal obesity as
measured by a higher WHR
did have an increased inci-
dence of DR. In other words
where the excess body fat was
located was a stronger risk
factor than just a higher BMI.
This makes sense as abdomi-
nal obesity is associated with
systemic inflammation, dys-
function of the cells that line
the blood vessels and throm-
bosis (development of blood
clots). To put it more simply
diabetics who were shaped
like an apple fared worse than
diabetics shaped like a pear
(my wording, not the study’s).
The authors of the study
suggested that more research
was needed but it is becom-
ing increasingly obvious that
measuring obesity by BMI
alone is insufficient to truly
assess the risk of developing
obesity-related diseases and
disease complications. Meas-
uring where the excess fat is
located using a tool like WHR
appears to provide a better as-
sessment of risk factors.
At any rate if you are over-
weight the fact that you are
shaped like an apple or pear
doesn’t lessen the impor-
tance of weight loss. If you
are overweight, losing weight
is probably the single most
important thing you can do
to improve your health. If
you are overweight, talk to
your doctor and a dietician
to come up with a weight
loss plan (a combination of
diet and exercise) that makes
sense for you.
Please direct questions and
comments to editor@rocka-
waytimes.com