2nd Edition of Diabetes and Endocrinology World Conference 2026

Abstract

Obesity, a heterogenous serious condition leading to multiple adverse health outcomes causing human suffering i.e, hypertension, heart failure, dyslipidemia, diabetes, non-alcoholic fatty liver disease, gallstones, reflux esophagitis, polycystic ovarian syndrome, sleep apnea, osteoarthritis, gout, stroke, dementia, cancers. Worse outcome, if infected by SARS-CoV-2. Waist circumference (WC), a measure of abdominal obesity, is a risk of CVD, independent of body mass index (BMI). Overweight (BMI:25.0-29.9kg/m2) has increased disease risk, Obesity, (Class I, BMI:30.0-34.9kg/m²), has high, Class II (35.0-39.9kg/m²), very high, Class III (Extreme obesity, BMI≥40kg/m²) has extremely high disease risk. Lifestyle changes lead to weight loss, reduces systemic inflammation and endothelial dysfunction. An inverse relationship between obesity and the progression of established CVD – a phenomenon known as “the obesity paradox”, explained by the malnutrition/inflammation complex syndrome (MICS) and endotoxin/ lipopolysaccharide hypothesis.

Liraglutide (GLP-1) analogue with 97% homology to human GLP-1, approved for the treatment of DM (T2) with 1.8mg once daily. In addition to its effect as an incretin hormone (glucose -induced insulin secretion), inhibits both gastric emptying, glucagon secretion and stimulates GLP-1 receptors in the arcuate nucleus of the hypothalamus to reduce feeding. Responsive target weight loss (4%). Tirzepatide, a glucose-dependent insulinotropic polypeptide (GIP)/glucagon like peptide-1(GLP-1) dual agonist, showed 22.5% weight loss in people with/without obesity, lowers inflammation, endothelial damage, improves blood vessel health. 10-20% reduction of body weight helps restore β-cell function. Patient appears lean, carry high levels of visceral fat, develop insulin resistance early “thin –fat” phenotype.

Dr David Barker, first conceptualized, Adult metabolic disease could have foetal origins. Irrevocable changes in metabolism, physiology, endocrine factors occur in low birth weight (LBW) babies in utero, leading to hypertension, diabetes, large for gestational age baby (LGA), obese, heart disease in adulthood, the “thrifty gene hypothesis”. Abundance of food after birth in (LBW) babies, “catch-up” growth, merits attention, is detrimental. Bisphenol (lipophilc) stored in adipose tissue, found in food additives used in processing, storage, transport, to increase shelf life. American College of Cardiology/American Heart Association/The Obesity Society (ACC/AHA/TOS), recommends routine waist circumference measurement, height, weight, to identify visceral obesity. Physical activity must be encouraged since childhood, better foetal outcome in pregnant women. For PCOS, weight loss is the mainstay. Bariatric surgery, advised in women BMI ≥40, with diabetes BMI ≥35. Insulin, sulphonylureas, glitazones are to be avoided, as they cause weight gain. Metformin, GLP1 analogues (liraglutide), SGLT2 inhibitors, cause weight loss. DPP IV inhibitors are weight neutral.

Aerobic exercise (150 min of moderate-intensity or 75 min of vigorous-intensity, spread throughout the week), improves oxygen uptake, quality of life. Dietary counselling as selected goals are SMART (specific, measurable, agreed upon, realistic, timely). Dietary restriction of macronutrients, low-fat, low carbohydrate diet, vegetarian diet. Meal replacements results in 7-8% weight loss. Intermittent fasting (IF), an alternative to traditional continuous calorie restriction (CR) for weight management and metabolic health. Method:16/8 (restrict food intake to an 8-hour window, fast for remaining 16-hours), reduces body weight, visceral fat, enhances insulin sensitivity, improve dyslipidemia, hormone regulation, improves glucose metabolism, reduces fasting insulin concentrations by 20-30%, HbA1c levels by 0.4-0.9% or prediabetes, reduces blood pressure (systolic 3-8 mmHg, diastolic by 2-7 mmHg), linked to decrease in LDL cholesterol (10-15%), triglyceride (10-25%). Positive impact and prevention of cancer, by reducing preneoplastic lesions (40-60%). Significantly alters gut microbiota, favors sleep. Fasting, mitigates the effects of aging by reducing oxidative stress.