Obesity and Diabetes: The Odd Couple

Obesity and mild carbohydrate intolerance tend to coexist in man. Obesity per se increases basal insulin secretion and insulin responses to glucose, while mild carbohydrate intolerance is associated with impaired insulin responses. Adiposity may cause decreased tissue sensitivity to insulin and reduced glucose uptake, which in turn leads to hyperinsulinism. Prolonged obesity may unmask genetic diabetes at an earlier stage to account in part for their frequent association. Abnormal insulin secretion and reduced sensitivity to its action also may be responsible for alterations of fat mobilization observed only in the presence of both obesity and mild carbohydrate in tolerance.