Medical Consequences of Obesity Pulmonary disease abnormal function obstructive sleep apnea hypoventilation syndrome Idiopathic intracranial hypertension Stroke Cataracts Nonalcoholic fatty liver disease steatosis steatohepatitis cirrhosis Coronary heart disease Diabetes Dyslipidemia Hypertension Gall bladder disease Gynecologic abnormalities abnormal menses infertility polycystic ovarian syndrome Cancer breast, uterus, cervix colon, esophagus, pancreas kidney, prostate Osteoarthritis Phlebitis venous stasis Skin Slide Source: Obesityonline.org Gout

Estimated Epidemiology of Diabetes

DM Prevalence in Indonesia 1982 6.1% 6.1% 1.6 % 1.5 % 2005 1984 1.1% 1.4% 1998 1992 2004 3.5 % Padang Jakarta Singaparna Pekajangan Makassar Surabaya Bali Manado 5.7 % 3.7% 2001 9.2% 12.5 % 14.7 % 2003 2005

Obesity is a key driver of the diabetes epidemic 50–65% of the general population are obese or overweight1 The risk of developing type 2 diabetes increases with increasing weight2 It is estimated that half of all diabetes cases would be eliminated if weight gain could be prevented3 50–65% of the general population, not only in the US, Europe and Australia, but also in lower to moderate income countries such as Mexico, Egypt and the black population of South Africa, are obese (BMI  30.0 kg/m2) or overweight (BMI 25.0–29.9 kg/m2).1 The link between obesity and diabetes is well established,2 with the vast majority of individuals with type 2 diabetes being overweight or obese. While the risk of diabetes increases with weight, several studies have shown that moderate weight loss and increased physical activity can prevent or delay the development of type 2 diabetes.3–5 The Diabetes Prevention Program, for example, found that the participants who increased their physical activity and lost 5–7% of their body weight (10–15 pounds or 4.5–7 kg) reduced their progression to diabetes by 58% during the course of the study.3 1International Diabetes Federation. Press Release: 09 November 2004. Available at: http://www.idf.org/home/ 2Mokdad AH, et al. JAMA 2003; 289:76–79. 3Knowler WC, et al. N Engl J Med 2002; 346:393–403. 4Tuomilehto J, et al. N Engl J Med 2001; 344:1343–1350. 5Pan XR, et al. Diabetes Care 1997; 20:537–544. 1http://www.idf.org/home/; 2Mokdad AH, et al. JAMA 2003; 289:76–79. 3Knowler WC, et al. N Engl J Med 2002; 346:393–403.

Complications of Diabetes Macro vascular Micro vascular Brain Cerebrovascular disease Transient ischemic attack Cerebrovascular accident Cognitive impairment Eye Retinopathy Cataracts Glaucoma Heart Coronary artery disease Coronary syndrome Myocardial infarction Congestive heart failure Kidney Nephropathy Microalbuminuria Gross albuminuria Kidney failure Extremities Peripheral vascular disease Ulceration Gangrene Amputation Nerves Neuropathy Peripheral Autonomic