PROJECT ON
“A REPORT ON LINKAGE BETWEEN
DIABETES AND OBESITY ”
A Report Submitted to
Dr. A.P.J. Abdul Kalam Technical University
for the award of the degree of
Bachelor of Pharmacy
By
ABHISHEK NAGAR
(Roll no. 1813350010)
Under the guidance of
Mrs. NIDHI SHARMA
(Assistant Professor)
NOIDA INSTITUTE OF ENGINEERING & TECHNOLOGY
PHARMACY INSTITUTE Greater Noida (201306)
Page No. 1
CERTIFICATE
The work described in this initiated “A REPORT ON LINKAGE BETWEEN DIABETES
AND OBESITY” has been carried out by [Link] Nagar under my supervision. I
certify that this is his bonafide work. The work described is original and has not been
submitted for any degree to this or any other university.
Date: Mrs. NIDHI SHARMA
Place: Greater Noida (Assistant Professor)
N.I.E.T. (Pharmacy Institute)
Page No. 2
STATEMENT BY THE CANDIDATE
As required by university regulation, I wish to state that this work embodied in this report
titled “A REPORT ON LINKAGE BETWEEN DIABETES AND OBESITY” forms my
own contribution to the research work carried out under the guidance of Mrs. NIDHI
SHARMA, Assistant Professor, Pharmacy Institute, NIET. This work has not been submitted
for any other degree at this or any other university. Whenever references have been made to
previous work of others, it has been clearly indicated as such and included in the
bibliography.
Forwarded Through Guide:
Name of Guide:
Mrs. NIDHI SHARMA
(Assistant Professor)
NIET, Pharmacy Institute
Greater Noida
Page No. 3
ACKNOWLEDGEMENT
It was an enriching and learning experience for me to do this project. I would like to
acknowledge all those people who have continuously guided me throughout and helped me
in the completion of my project “A REPORT ON LINKAGE BETWEEN DIABETES
AND OBESITY”.
I want to thank Mrs. NIDHI SHARMA, (Assistant Professor) for her inestimable guidance,
valuable suggestions, and constant encouragement during the course of this study.
Sincere gratitude to Dr. Avijit Mazumdar, Professor, and Director, and Dr. Rupa Mazumdar,
Professor and Dean, for their constant moral support, direction, and selfless support
throughout the research work.
I am also grateful to all my teachers for their guidance during the project work.
I would also like to thank my classmates who give me moral support & encouragement to
complete my entire study of the project.
ABHISHEK NAGAR
(1813350010)
Page No. 4
DECLARATION
I hereby declare the project work entitled as “A REPORT ON LINKAGE BETWEEN
DIABETES AND OBESITY” is my own work and to the best of my knowledge and belief,
it contains no material previously published or written. This work has not been submitted for
any other degree at this or any other university.
ABHISHEK NAGAR
B. Pharmacy (4th year)
Page No. 5
INDEX
S. NO. CHAPTERS TOPIC
1 Chapter 1 Introduction
2 Chapter 2 Literature review
3 Chapter 3 Aim and objective
4 Chapter 4 Methodology
5 Chapter 5 Results and Findings
6 Chapter 6 Discussions
7 Chapter 7 Conclusions
8 References
A survey of the link between obesity with diabetes millets.
Page No. 6
INTRODUCTION
Page No. 7
INTRODUCTION
The relationship between obesity and diabetes is so interdependent that the term ‘diabesity’
has been created. From obesity to diabetes is an ongoing mistake in insulin production
accompanied by a continuous increase in insulin resistance.
The accumulation of large amounts of body fat can cause type 2 diabetes, and the risk of type
2 diabetes increases with the increase in body weight. Thus, the worldwide increase in
obesity has led to a dramatic rise in type 2 diabetes mellitus. obese people, the amount of
unconfirmed fatty acids, glycerol, hormones, cytokines, symptoms that cause inflammation,
and other factors involved in the production of insulin resistance, increases. Weight gain and
body weight are the basis of the formation and the growing incidence of type 1 and sort 2
diabetes.
Page No. 8
DIABETES MELLITUS
Diabetes mellitus (DM) is an incurable disease that can change the metabolism of the
carbohydrates, proteins, and fats body. It is caused by a lack of insulin production due to
progress or continuity or significant failure of β-Langerhans islet cells of the pancreas to
produce insulin, or due to impairment in insulin receptors in the lateral muscle.
There are two main types of diabetes:
➔ Type 1 Diabetes
➔ Type 2 Diabetes
TYPE 1 DIABETES:
Type 1 diabetes, formerly known as childhood diabetes or insulin-dependent diabetes
mellitus, is a chronic condition in which the pancreas produces little or no insulin. Insulin is a
hormone needed for glucose to enter cells to produce energy.
A variety of factors, including genetics and other viruses, may play a role in diabetes.
Although Type 1 diabetes often occurs in childhood or adolescence, it can develop in adults.
Despite effective research, type 1 diabetes has no cure. Treatment focuses on controlling
blood sugar levels with insulin, diet, and lifestyle to prevent complications.
➢ Symptoms
Type 1 diabetes signs and symptoms can appear relatively suddenly and should include:
❖ Increased thirst
❖ Frequent urination
❖ Bed-wetting in children who previously didn't wet the bed during the night
❖ Extreme hunger
❖ Unintended weight loss
❖ Irritability and other mood changes
❖ Fatigue and weakness
❖ Blurred vision
➢ Causes
The exact explanation for type 1 diabetes is unknown. In general, the immune system -
which normally fights harmful bacteria and viruses - accidentally destroys
insulin-producing cells (islet, or Langerhans) in the gut. Other possible causes include
❖ Genetics
❖ Exposure to viruses and other environmental factors
➢ Prevention
There is no known cure for type 1 diabetes. But researchers are working to prevent this
disease or further destruction of islet cells in newly discovered people.
Page No. 9
TYPE 2 DIABETES:
Diabetes mellitus is a disorder in which the body regulates and uses glucose as fuel. This
chronic condition causes high levels of sugar in the blood. Finally, high blood sugar levels
can lead to disorders of the circulatory system, the nervous system, and the immune system.
With Type 2 diabetes, Your pancreas does not produce enough insulin - the hormone that
controls the flow of sugar in your cells - and cells respond poorly to insulin and absorb less
sugar.
Type 2 diabetes is formerly known as adult-onset [Link] it starts in adults, both types
1 and type 2 diabetes can start in childhood and in adulthood. Type 2 is more common in
older adults, but an increase in the number of obese children has led to more cases of type 2
diabetes in young people.
There is no cure for type 2 diabetes, but losing weight, eating well, and exercising can help
you to control it. If diet and exercise are not enough to control your blood sugar, you may
also need diabetes medication or insulin treatment.
➢ Symptoms
Signs and symptoms of type 2 diabetes often develop slowly. In fact, you'll be living with
type 2 diabetes for years and not realize it. When signs and symptoms are present, they
may include:
❖ Increased thirst
❖ Frequent urination
❖ Increased hunger
❖ Unintended weight loss
❖ Fatigue
❖ Blurred vision
❖ Slow-healing sores
❖ Frequent infections
❖ Numbness or tingling in the hands or feet
❖ Areas of darkened skin, usually in the armpits and neck
➢ Causes
Type 2 diabetes is primarily the results of two interrelated problems:
❖ Cells in muscle, fat and the liver become resistant to insulin. Because these cells
don't interact in a normal way with insulin, they do not absorb enough sugar.
❖ The pancreas is unable to produce enough insulin to manage blood sugar levels.
Exactly why this happens is unknown, but being overweight and inactive are key
contributing factors.
➢ Risk Factors
Factors that may increase your threat of type 2 diabetes include
❖ Weight- Being fat or fat is the main threat.
❖ Fat distribution- Storing fat substantially in your tummy rather than your hips
and shanks indicates a lesser threat. Your threat of type 2 diabetes rises if you are
a man with a midriff circumference above 40 elevations (101.6 cm) or a woman
with a dimension above 35 elevations (88.9 cm).
Page No. 10
❖ Inactivity-The less active you are, the lesser your threat. Physical exertion helps
control your weight, uses up glucose as energy and makes your cells more
sensitive to insulin.
❖ The family history-The threat of type 2 diabetes increases if your parent or stock
has type 2 diabetes.
❖ Race and race- Although it's unclear why, people of certain races and races
including Black, Hispanic, Native American and Asian people, and Pacific
Islanders are more likely to develop type 2 diabetes than white people are.
❖ Blood lipid situations- The increased threat is associated with low situations of
high-viscosity lipoprotein (HDL) cholesterol the "good" cholesterol and high
situations of triglycerides.
❖ Age- The threat of type 2 diabetes increases as you get older, especially after age
45.
❖ Prediabetes- Prediabetes is a condition in which your blood sugar position is
more advanced than normal, but not high enough to be classified as diabetes. Left
undressed, prediabetes frequently progresses to class 2 diabetes.
❖ Pregnancy-related pitfalls. Your threat of developing type 2 diabetes increases if
you developed gravid diabetes when you were pregnant or if you gave birth to a
baby importing further than 9 pounds (4 kilograms).
❖ Polycystic- ovary pattern. Having a polycystic ovary pattern a common condition
characterized by irregular menstrual ages, redundant hair growth, and obesity
increases the threat of diabetes
❖ Areas of darkened skin- generally in the armpits and neck. This condition
frequently indicates insulin resistance.
➢ Prevention
Healthy, life changes may decelerate or stop the progression of diabetes.
A healthy life includes:
❖ Eating healthy foods- Choosing foods lower in fat and calories and advanced in
fiber. Focus on fruits, and vegetables
❖ Getting active- Aim for 140 min or more a week of moderate to vigorous aerobic
exertion, like a workout, running, or swimming.
❖ Losing weight- Losing a small quantity of weight and keeping it off can delay the
progression from prediabetes to class 2 diabetes. However, losing 7 to 10% of
your body weight can reduce the threat of diabetes, If you have prediabetes.
❖ Avoiding inactivity for long ages- Sitting still for long ages can increase your
threat of type 2 diabetes. Try to get up every 30 twinkles and move around for at
least a many twinkles.
Page No. 11
OBESITY
Obesity is a complex disease that involves in accumulation of excess fat in the body. It's a
health problem that increases the threat of other conditions and health problems, similar to
heart complaints, diabetes, high blood pressure, and other cancers.
There are numerous reasons why some people have difficulty losing weight. Generally,
Obesity is a result of heredity, physical and environmental factors, including diet, exercise,
and exercise choices.
➢ Symptoms
With the metric system, the formula for BMI is weight in kilograms divided by height
in meters squared. Because height is commonly measured in centimeters, divide height
in centimeters by 100 to obtain height in meters.
BMI Weight status
Below 18.5 Underweight
18.5-24.9 Normal
25.0-29.9 Overweight
30.0 and higher Obesity
➢ Risk Factors
Obesity generally results from a combination of causes and contributing factors
Family Heritage and influences
The genes you inherit from your parents may affect the amount of body fat you store, and
where that fat is distributed. Genetics may also play a part in how efficiently your body
converts food into energy, how your body regulates your appetite, and how your body
burns calories during exercise.
Obesity tends to run in families. That is not just because of the genes they share. Family
members also tend to share similar eating and activity habits.
Life choices
❖ Unhealthy diet. A diet that is high in calories, lacking in fruits and vegetables, full
of fast food and laden with high-calorie beverages and large portions contribute to
weight gain.
❖ Liquid calories. People can drink numerous calories without feeling full,
especially calories from alcohol. Other high-calorie potables, similar to sugared
soft drinks, can contribute to significant weight gain.
❖ Inactivity - you can fluently take in further calories every day than you burn
through exercise and routine quotidian exertion If you have a sedentary life.
Looking at the computer, tablet and phone defenses is a sedentary exertion. The
number of hours spent in front of a screen is largely associated with weight gain.
Certain conditions and medications
Page No. 12
Social and economic issues-
Social and economic factors are linked to obesity. Avoiding obesity is delicate if you do
not have safe areas to walk or exercise. Also, you may not have been tutored in healthy
ways of cooking, or you may not have access to healthier foods. In addition, the people
you spend time with may impact your weight — you are more likely to develop obesity if
you have friends or cousins with obesity.
Age-
obesity can occur at any age, indeed in immature children. But as you age, hormonal
changes and a less active life increase your trouble of obesity. In addition, the amount of
muscle in your body tends to drop with age. Generally, lower muscle mass leads to a drop
in metabolism.
These changes also reduce calorie conditions and can make it harder to keep off
redundant weight. However, you will presumably gain weight, If you do not designedly
control what you eat and become more physically active as you age, you’ll likely gain
weight.
Other factors-
● Pregnancy- Weight gain is common during gestation. Some women find this
weight delicate to lose after the baby is born. This weight gain may contribute to
the development of obesity in women.
● Quitting smoking- Quitting smoking is constantly associated with weight gain.
And for some, it can lead to enough weight gain to qualify as obesity. Constantly,
this happens as people use food to manage smoking withdrawal. In the long run,
still, quitting smoking is still a lower benefit to your health than is continuing to
bomb. Your croaker can help you help weight gain after quitting smoking.
● Lack of sleep- Not getting enough sleep or getting too important sleep can beget
changes in hormones that increase appetite. You may also crave foods high in
calories and carbohydrates, which can contribute to weight gain.
● Stress- Numerous external factors that affect mood and well-being may contribute
to obesity. People constantly seek more high-calorie food when passing stressful
situations.
● Microbiome-Your gut bacteria are affected by what you eat and may contribute to
weight gain or difficulty losing weight.
Indeed if you have one or further of these trouble factors, it does not mean that you are fated
to develop obesity. You can neutralize utmost trouble factors through diet, physical exertion,
and exercise.
Page No. 13
Literature Review
Page No. 14
Obesity and Type 1 Diabetes
Type 1 and type 2 diabetes cases are increasing day by day and they are linked to the
epidemic of obesity
Type 1 Diabetes is an autoimmune disorder and Its pathophysiology is continued to
investigate the exact mechanism of Type 1 Diabetes is still unclear
According to the Diamond (Diabetes Mandiale) studies 2.8% percent Annual increase in
childhood diabetes (Type 1) data is collected from 112 centers around the world from the
period 1989-2000.
According to twin studies, the etiology of Type 1 Diabetes is mainly related to two factors
1. Environment factors and 2. Genetic factors
The environmental factor indicate a significant rise in Type 1 Diabetes, especially in the
immigrants. High rates of diabetes mellitus prediabetes and obesity are seen in refugees and
immigrants which is mainly triggered by changes in environmental factors and leads to
obesity and diabetes.
Multiple triggers of Type 1 Diabetes mellitus are investigated including
1. Exposure to cow milk protein
2. Exposure to injections like rubella and enterovirus.
3. Absent and short duration of breastfeeding.
The Accelerator hypothesis
The Baum et al Costly firstly investigate the association between weight gain and Type1
Diabetes. The Baum et al study suggested Type1 diabetes and weight gain are associated with
overfeeding and hormonal dysregulation.
The Accelerator hypothesis identifies three processes which variable accelerated the loss of
Beta-cell through apoptosis insulin resistance and autoimmunity. These accelerators lead to
diabetes with excess weight gain causing an increase in insulin resistance which leads to
weakening of glucose control.
The rising blood glucose (glucotoxicity) increases the rate of Beta-cell apoptosis directly in
all and by inducing beta-cell immunogens, further accelerates it in a subset genetically
predisposed to autoimmunity. Body mass is Central to the development and rising indicates
of all diabetes
one study showed 24.2 percent of Type 1 Diabetes among overweight children in the United
States.
A significant increase in the rate of being overweight in children with Type 1 Diabetes
Obesity and Type 2 Diabetes
ADIPOSE TISSUE AND INSULIN RESISTANCE
Adipose tissue is also known as body fat and it is found all over the body, under
subcutaneous fat, present around internal organs between muscle, bone marrow and in breast
tissue. It plays an important role in the regulation and releasing of energy throughout the
human body and it also plays important role in the regulation of glucose, cholesterol, and the
metabolism of sex hormone
Adipose tissue manages the long-term change in energy level that causes adipose tissue
expansion or reduction and this Specific adaptive response of adipose tissue to its expansion
According to a study conducted on mice, the model of obesity demonstrates a series of
complex but interactive biological processes in adipose tissue that contributes to whole-body
Page No. 15
insulin resistance including adipocyte oxygen inadequate delivery. which simulates adipose
oxygen demand which stimulates adipose fibrogenesis and Macrophage chemotaxis.
It suppresses Adipose tissue branched-chain amino acid catabolism which stimulates plasma
branched-chain amino acid catabolism and increases Proinflammatory immune cell
(microphase and T cells) content and expression of genes that encode proinflammatory
protein production of Exosomes that can induce insulin resistance. Their factors in aggregate
may include insulin resistance. This study is conducted on the Mouse model of obesity the
importance in the pathogenesis of insulin resistance in people is less clear or not yet
validated.
Page No. 16
Page No. 17
AIM
BASED ON THE DATA OBTAINED DURING A REPORT ON LINKAGE BETWEEN
DIABETES AND OBESITY
OBJECTIVE
There are the following objective of my survey for Obesity linked with Diabetes:
1. To find out the prevalence of Diabetes and obesity amongst different genders and
ages.
2. To find out how many people want to lose weight.
3. To find out which method people use to lose weight
4. To find out most Leisure time physical activity of patients.
5. To find out the most prevalent factors that cause Diabetes
METHODOLOGY
The analysis was used to determine the linkage between Obesity and Diabetes. The work was
conducted in all major centers. Each area was further divided into a large city, a small town,
and a village. The total sample size was around 50+ subjects. Respondents for different age
groups were required to complete a survey form. The tools contain a systematic questionnaire
and a survey analysis.
STUDY DESIGN
At each study site, local residents were selected and conducted a survey related to the linkage
between Diabetes and obesity with this random sample.
Respondents who did not have symptoms of Diabetes and Obesity were not asked any more
questions, but those who confirmed Diabetes and Obesity symptoms were asked more
questions.
Page No. 18
NO. OF SUBJECTS IN SURVEY/STUDY POPULATION
56 SUBJECTS
STUDY INCLUSION CRITERIA
All subjects who are in the normal to an obese range of weight
STUDY EXCLUSION CRITERIA
All subjects who is in the underweight category.
INVESTIGATORS
1) Mrs. Nidhi Sharma (ASSISTANT PROFESSOR OF NOIDA INSTITUTE OF
ENGINEERING AND TECHNOLOGY, GREATER NOIDA, AFFILIATED BY
DR. A.P.J. ABDUL KALAM TECHNICAL UNIVERSITY, LUCKNOW) &
2) [Link] Nagar (STUDENT PURSUING B PHARMACY IN NOIDA
INSTITUTE OF ENGINEERING AND TECHNOLOGY, GREATER NOIDA,
AFFILIATED BY DR. A.P.J. ABDUL KALAM TECHNICAL UNIVERSITY,
LUCKNOW)
QUESTIONNAIRE
It was attached below
CONFIDENTIALITY
Confidentiality was maintained till the end.
Page No. 19
Results
&
Discussion
Page No. 20
re
Page No. 21
Page No. 22
Page No. 23
What Type of food do you Eat?
Page No. 24
Page No. 25
Page No. 26
Page No. 27
DISCUSSION
We have conducted a survey to find out the possible linkage between obesity & Diabetes. we
have created a google form, containing various questions. The work was conducted on
different North states of India. Google form was circulated to people in the normal to obese
weight category. Data was collected and analyzed we found out that obesity has directly
Linked to diabetes based on our Questionnaires & literature review. There is no cure for
diabetes, but losing weight, eating well & exercising can help you to control it.
Impact of vegetarian & nonvegetarian diet on Diabetes need to study further
CONCLUSION
Our study shows that Obesity is one of the main causes of Diabetes. 44.6% of our
volunteers are inactive, and 48% of volunteers want to lose weight.
Obesity, less exercise, and wrong eating habits come out as the main cause of Diabetes
A sedentary lifestyle and consumption of low-density lipoprotein are leading generations
towards the epidemic of obesity and diabetes.
Both obesity and diabetes are largely preventable. the study suggested that the change in
lifestyle is effective in preventing diabetes and obesity in the patients who are at higher risk.
Page No. 28
REFERENCE
1. Scheen AJ. Pathophysiology of type 2 diabetes. Acta Clin Belg. 2003;58(6):335–341.
2. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes
Care. 2007;30 Suppl 1:S42–S47.
3. Hutton JC, Davidson HW. Cytokine-induced dicing and splicing in the β-Cell and the
immune response in Type 1 Diabetes. Diabetes. 2010;59(2):335–336.
4. van Belle TL, Coppieters KT, von Herrath MG. Type 1 diabetes: etiology, immunology,
and therapeutic strategies. Physiol Rev. 2011;91(1):79–118.
5. Mathieu C, Badenhoop K. Vitamin D and type 1 diabetes mellitus: state of the art. Trends
Endocrinol Metab. 2005;16(6):261–266.
6. Philippe MF, Benabadji S, Barbot-Trystram L, Vadrot D, Boitard C, Larger E. Pancreatic
volume and endocrine and exocrine functions in patients with diabetes. Pancreas.
2011;40(3):359–363.
Page No. 29
[Link], M., and Bergman, R.N. (1990). Peripheral effects of insulin dominant suppression of
fasting hepatic glucose production. Am. J. Physiol. 258, E1020–E1032.
[Link], M.C., Poggi, M., and Juhan-Vague, I. (2007). Plasminogen activator inhibitor-1,
adipose tissue, and insulin resistance. Curr. Opin. Lipidol. 18, 240–245.
[Link], M., and Gerich, J.E. (2017). Renal glucose metabolism in normal physiological
conditions and in diabetes. Diabetes Res. Clin. Pract. 133, 1–9.
[Link], M., Gordillo, R., Koliaki, C., Gancheva, S., Jelenik, T., De Filippo,E.,
Herder, C., Markgraf, D., Jankowiak, F., Esposito, I., et al. (2018). Specifichepatic
sphingolipids relate to insulin resistance, oxidative stress, and inflammation in nonalcoholic
steatohepatitis. Diabetes Care 41, 1235–1243.
[Link], P., and Ryde´ n, M. (2015). Fatty acids, obesity and insulin [Link]. Facts
8, 147–155.
[Link], D.E., Bogart, A., Sherwood, N.E., Sidney, S., Coleman, K.J., Haneuse,S.,
O’Connor, P.J., Theis, M.K., Campos, G.M., McCulloch, D., andSelby, J. (2013). A multisite
study of long-term remission and relapse of type2 diabetes mellitus following gastric bypass.
Obes. Surg. 23, 93–102
Questionnaire
[Link]:
Male
Female
[Link]
Under 18
18-25
25-35
35-45
45-55
55 and Above
Page No. 30
[Link]
Uttar Pradesh
Jammu & Kashmir
Punjab
Uttrakhand
Delhi
Rajasthan
Haryana
[Link] in kg
below 40 kg:
40-50 kg:
50-60 kg:
60-70 kg:
70-80 kg:
80-90 kg:
90 and above:
[Link]
below 1.4 m:
1.4-1.5 m:
1.5-1.6 m:
1.6-1.7 m:
1.7-1.8 m:
1.8-1.9 m:
[Link] you want to lose weight
Yes
No
Maintaing current weight
Q7. Which method you are using to lose weight?
Physical activity
Dieting
Both
Other
Q8. What types of food do you eat?
Vegitarian food
Page No. 31
BOTH
Non Vegitarian food
[Link]-time physical activities
Inactive
Irregularly
ActiveRegular,
Not intense
Regular, Intense
10. Are you diabetic?
Yes
No
currently No, but i feel like i will be
Q11. What type of Diabetes do you have ?
Type 1 Diabetes
Type 2 Diabetes
Do not know
Q12. What type of Diabetes do you have ?
Type 1 Diabetes
Type 2 Diabetes
Do not know
[Link] are the main causes that made you Diabetic?
Less exercise
Wrong eating habits
Page No. 32
Obesity
Environmental factors
family history
Page No. 33