Metabolic Management
|
April 11, 2024

The Vicious Cycle of Obesity, Diabetes, and Hypertension: Breaking Free

Medically Reviewed by
Updated On
September 17, 2024

Struggling with the challenges of obesity, hypertension, and diabetes can feel like navigating a labyrinth with no clear exit, each condition compounding the difficulties of the others. In the United States, it is a struggle that many face: 41.9% of adults are obese, nearly 50% have high blood pressure, and 11% of the population have diabetes.Β 

This article will shed light on the intricate relationship between these health concerns and provide straightforward explanations of how they feed into each other, creating a cycle that can seem impossible to break. We'll explore why these conditions often coexist, offering practical strategies that anyone can understand and implement to achieve better health outcomes.Β 

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Obesity - Diabetes - Hypertension: How Are They Connected?

Obesity is defined as having too much body mass and is classified by body mass index (BMI). A BMI of 30 or higher is diagnostic for adult obesity. A BMI of 40 or higher is considered severe obesity. (37)Β 

Adipose (fat) tissue secretes pro-inflammatory molecules called adipokines, such as TNF-alpha and IL-6, which interfere with insulin signaling pathways, reducing insulin sensitivity in peripheral tissues like muscle and liver. This insulin resistance leads to impaired glucose uptake and utilization, ultimately increasing blood sugar levels and raising the risk of developing type 2 diabetes. (46, 47)

Hypertension, commonly known as high blood pressure, is characterized by elevated pressure within the arteries. Obesity elevates the risk of hypertension through various mechanisms. Firstly, adipokines promote systemic inflammation and endothelial dysfunction, which can impair blood vessel function and contribute to hypertension. Additionally, obesity is often associated with increased sympathetic nervous system activity and activation of the renin-angiotensin-aldosterone system (RAAS), both of which can raise blood pressure. (45)Β 

Similarly, diabetes is a risk factor for hypertension. Chronic elevations in blood sugar induce oxidative stress within the arterial walls, which damages the endothelial lining. This endothelial dysfunction impairs the ability of blood vessels to dilate and regulate blood pressure effectively. Diabetes also induces alterations in the RAAS, promoting sodium retention and higher blood pressure. (40)

It's common for obesity, high blood pressure, and diabetes to coexist. Metabolic syndrome is a cluster of metabolic abnormalities, including central obesity, elevated blood pressure, high blood sugar levels, and dyslipidemia, which collectively increase the risk of cardiovascular disease (CVD).

The Impact of This Cycle on Health

Obesity significantly increases the risk of developing a wide range of health problems, including type 2 diabetes, cardiovascular disease, certain cancers, musculoskeletal disorders, and respiratory issues. Additionally, obesity is associated with psychological and social challenges such as depression, low self-esteem, and stigma. (38)Β 

Health complications related to diabetes include CVD, neuropathy (nerve damage), nephropathy (kidney damage), retinopathy (eye damage), and an increased risk of infections. Uncontrolled diabetes can significantly reduce quality of life and life expectancy.

Hypertension places strain on the heart, arteries, and other organs, increasing the risk of heart attack, stroke, kidney disease, and vision loss. It is often referred to as the "silent killer" because it typically presents with no symptoms until serious complications arise.

When obesity, diabetes, and hypertension coexist, they compound the risk of developing CVD, which remains the leading cause of morbidity and mortality worldwide. The combination of these conditions creates a perfect storm of metabolic dysfunction, chronic inflammation, and vascular damage, significantly increasing the risk of heart attacks, strokes, and other cardiovascular events.Β 

Interestingly, one condition often exacerbates the progression and complications of the others, forming a detrimental cycle that further compromises health and well-being. Therefore, it is important to address these conditions collectively rather than in isolation.

Breaking the Cycle: Lifestyle Interventions

Incorporating evidence-based dietary changes, regular physical activity, and weight management strategies into daily routines can empower individuals to break free from the detrimental cycle of obesity, hypertension, and diabetes, leading to improved metabolic health and overall well-being.

Dietary Changes

Emphasizing a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can significantly improve metabolic health. Evidence suggests that adopting dietary patterns such as the Mediterranean diet or the Dietary Approaches to Stop Hypertension (DASH) diet can effectively lower blood pressure, improve insulin sensitivity, and aid in weight management.

Research has shown that adherence to the Mediterranean diet, characterized by high consumption of fruits, vegetables, nuts, olive oil, and fish, is associated with a reduced risk of obesity, type 2 diabetes, and hypertension.Β 

Similarly, the DASH diet, which prioritizes fruits, vegetables, low-fat dairy, whole grains, and lean proteins while limiting sodium intake, has been shown to lower blood pressure and improve cardiovascular health.

Physical Activity

Regular physical activity is paramount for managing obesity, hypertension, and diabetes. Aerobic exercise and resistance training offer numerous health benefits, including weight loss, improved insulin sensitivity, and reduced blood pressure.Β 

The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise per week, supplemented with muscle-strengthening activities two or more days per week.

Studies have demonstrated that engaging in regular physical activity can lead to significant improvements in metabolic parameters. Aerobic exercise has been shown to lower blood pressure, reduce visceral fat accumulation, and enhance insulin sensitivity, thereby reducing the risk of cardiovascular events. Likewise, resistance training can increase muscle mass, improve glycemic control, and lower blood pressure, contributing to better overall metabolic health.

Weight Management

Achieving and maintaining a healthy weight is crucial for managing obesity, hypertension, and diabetes. Caloric restriction, portion control, and mindful eating are essential strategies for weight management. Incorporating dietary modifications and regular physical activity into daily routines can promote sustainable weight loss and prevent weight regain over time. (9, 46)Β 

Numerous studies have demonstrated the effectiveness of lifestyle interventions for weight management and metabolic health. For instance, the Diabetes Prevention Program (DPP) study found that lifestyle modifications focusing on dietary changes and increased physical activity reduced the incidence of type 2 diabetes by 58% among high-risk individuals.Β 

Additionally, the Look AHEAD trial showed that intensive lifestyle interventions, including dietary counseling and exercise programs, led to significant weight loss and improvements in cardiovascular risk factors among adults with obesity and type 2 diabetes.

Medical and Pharmacological Interventions

Medications may play a crucial role in managing obesity, hypertension, and diabetes, but they should be used as part of a comprehensive treatment approach that includes lifestyle interventions and ongoing medical supervision.Β 

By addressing both pharmacological and non-pharmacological aspects of care, individuals can achieve better control of their conditions and reduce the risk of complications associated with obesity, hypertension, and diabetes.

Antidiabetic Medications

Oral antidiabetic medications, including metformin, sulfonylureas, and thiazolidinediones, are commonly prescribed to manage type 2 diabetes by improving insulin sensitivity, stimulating insulin secretion, or reducing glucose production in the liver.

Injectable medications like glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and insulin are used to control blood sugar levels in individuals with diabetes. GLP-1 RAs promote insulin secretion, suppress glucagon release, and slow gastric emptying, improving glycemic control and weight loss.

Antihypertensive Medications

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) block the effects of angiotensin II, a hormone that constricts blood vessels, lowering blood pressure and reducing the risk of cardiovascular events.

Calcium channel blockers (CCBs) relax blood vessels and decrease the heart's workload, effectively lowering blood pressure.

Diuretics help the body eliminate excess sodium and water, reducing blood volume and blood pressure.

Weight Loss Medications

The FDA has approved five drugs for long-term treatment of overweight and obesity:

  • Phentermine-topiramate (Qsymia) suppresses appetite and promotes satiety, leading to weight loss.Β 
  • Orlistat (Xenical) works by inhibiting the absorption of dietary fats in the intestines, resulting in reduced calorie intake and weight loss.
  • Bupropion-naltrexone (Contrave) targets the brain's hunger and reward centers to decrease appetite and cravings while increasing feelings of fullness.
  • In addition to their role in managing diabetes, the GLP-1 RAs liraglutide (Saxenda) and semaglutide (Wegovy) have been approved for weight management in individuals with obesity.

The Role of Monitoring and Support

Regular health monitoring, including tracking blood sugar levels, blood pressure readings, weight, and fitness levels, allows individuals and healthcare providers to track progress, identify trends, and make informed decisions regarding treatment adjustments. By staying vigilant and proactive in monitoring their health, individuals can better manage their conditions and reduce the risk of complications. (19)Β 

Evidence suggests regular health monitoring, support, and patient education can significantly improve health outcomes. Research indicates that individuals who regularly monitor health parameters (e.g., blood pressure, weight, and fitness markers) are more likely to achieve their health goals. Moreover, interventions that incorporate support from healthcare providers, family, and support groups have been associated with improved medication adherence, lifestyle adherence, and overall health-related quality of life. (23, 25, 32, 44)Β 

Preventive Measures

Obesity, hypertension, and type 2 diabetes are largely preventable conditions that can be mitigated through modifiable risk factors. Individuals can significantly reduce their risk of developing cardiometabolic diseases by implementing healthy eating habits, engaging in regular physical activity, managing stress levels, maintaining a healthy weight, and avoiding tobacco use. These lifestyle factors promote a healthy metabolism, improve insulin sensitivity, and support optimal cardiovascular health.Β 

Scheduling routine health check-ups for early detection and intervention of cardiometabolic dysfunction is essential. By monitoring blood pressure, blood sugar levels, and weight, individuals can identify risk factors early and work with healthcare providers to implement preventive strategies before chronic disease sets in.Β 

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Key Takeaways

Breaking free from the vicious cycle of obesity, diabetes, and hypertension is entirely within reach through informed lifestyle choices, medical intervention, and ongoing support. Individuals can take control of their cardiometabolic health by adopting healthy eating habits, engaging in regular physical activity, and working closely with healthcare providers to manage underlying conditions.

Struggling with the challenges of obesity, hypertension, and diabetes can feel like navigating a labyrinth with no clear exit, each condition compounding the difficulties of the others. In the United States, it is a struggle that many face: 41.9% of adults are obese, nearly 50% have high blood pressure, and 11% of the population have diabetes.Β 

This article will shed light on the intricate relationship between these health concerns and provide straightforward explanations of how they feed into each other, creating a cycle that can seem challenging to break. We'll explore why these conditions often coexist, offering practical strategies that anyone can understand and implement to support better health outcomes.Β 

[signup]

Obesity - Diabetes - Hypertension: How Are They Connected?

Obesity is defined as having too much body mass and is classified by body mass index (BMI). A BMI of 30 or higher is diagnostic for adult obesity. A BMI of 40 or higher is considered severe obesity. (37)Β 

Adipose (fat) tissue secretes pro-inflammatory molecules called adipokines, such as TNF-alpha and IL-6, which can interfere with insulin signaling pathways, potentially reducing insulin sensitivity in peripheral tissues like muscle and liver. This insulin resistance may lead to impaired glucose uptake and utilization, which can increase blood sugar levels and raise the risk of developing type 2 diabetes. (46, 47)

Hypertension, commonly known as high blood pressure, is characterized by elevated pressure within the arteries. Obesity may elevate the risk of hypertension through various mechanisms. Firstly, adipokines can promote systemic inflammation and endothelial dysfunction, which might impair blood vessel function and contribute to hypertension. Additionally, obesity is often associated with increased sympathetic nervous system activity and activation of the renin-angiotensin-aldosterone system (RAAS), both of which can raise blood pressure. (45)Β 

Similarly, diabetes is a risk factor for hypertension. Chronic elevations in blood sugar may induce oxidative stress within the arterial walls, which can damage the endothelial lining. This endothelial dysfunction might impair the ability of blood vessels to dilate and regulate blood pressure effectively. Diabetes also induces alterations in the RAAS, promoting sodium retention and higher blood pressure. (40)

It's common for obesity, high blood pressure, and diabetes to coexist. Metabolic syndrome is a cluster of metabolic abnormalities, including central obesity, elevated blood pressure, high blood sugar levels, and dyslipidemia, which collectively may increase the risk of cardiovascular disease (CVD).

The Impact of This Cycle on Health

Obesity may significantly increase the risk of developing a wide range of health problems, including type 2 diabetes, cardiovascular disease, certain cancers, musculoskeletal disorders, and respiratory issues. Additionally, obesity is associated with psychological and social challenges such as depression, low self-esteem, and stigma. (38)Β 

Health complications related to diabetes include CVD, neuropathy (nerve damage), nephropathy (kidney damage), retinopathy (eye damage), and an increased risk of infections. Uncontrolled diabetes can significantly reduce quality of life and life expectancy.

Hypertension places strain on the heart, arteries, and other organs, increasing the risk of heart attack, stroke, kidney disease, and vision loss. It is often referred to as the "silent killer" because it typically presents with no symptoms until serious complications arise.

When obesity, diabetes, and hypertension coexist, they may compound the risk of developing CVD, which remains the leading cause of morbidity and mortality worldwide. The combination of these conditions creates a perfect storm of metabolic dysfunction, chronic inflammation, and vascular damage, significantly increasing the risk of heart attacks, strokes, and other cardiovascular events.Β 

Interestingly, one condition often exacerbates the progression and complications of the others, forming a detrimental cycle that further compromises health and well-being. Therefore, it is important to address these conditions collectively rather than in isolation.

Breaking the Cycle: Lifestyle Interventions

Incorporating evidence-based dietary changes, regular physical activity, and weight management strategies into daily routines can empower individuals to break free from the detrimental cycle of obesity, hypertension, and diabetes, potentially leading to improved metabolic health and overall well-being.

Dietary Changes

Emphasizing a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can support metabolic health. Evidence suggests that adopting dietary patterns such as the Mediterranean diet or the Dietary Approaches to Stop Hypertension (DASH) diet may help lower blood pressure, improve insulin sensitivity, and aid in weight management.

Research has shown that adherence to the Mediterranean diet, characterized by high consumption of fruits, vegetables, nuts, olive oil, and fish, is associated with a reduced risk of obesity, type 2 diabetes, and hypertension.Β 

Similarly, the DASH diet, which prioritizes fruits, vegetables, low-fat dairy, whole grains, and lean proteins while limiting sodium intake, has been shown to support lower blood pressure and improve cardiovascular health.

Physical Activity

Regular physical activity is important for managing obesity, hypertension, and diabetes. Aerobic exercise and resistance training offer numerous health benefits, including weight loss, improved insulin sensitivity, and reduced blood pressure.Β 

The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise per week, supplemented with muscle-strengthening activities two or more days per week.

Studies have demonstrated that engaging in regular physical activity can lead to significant improvements in metabolic parameters. Aerobic exercise has been shown to support lower blood pressure, reduce visceral fat accumulation, and enhance insulin sensitivity, thereby reducing the risk of cardiovascular events. Likewise, resistance training can increase muscle mass, improve glycemic control, and lower blood pressure, contributing to better overall metabolic health.

Weight Management

Achieving and maintaining a healthy weight is crucial for managing obesity, hypertension, and diabetes. Caloric restriction, portion control, and mindful eating are essential strategies for weight management. Incorporating dietary modifications and regular physical activity into daily routines can promote sustainable weight loss and help prevent weight regain over time. (9, 46)Β 

Numerous studies have demonstrated the effectiveness of lifestyle interventions for weight management and metabolic health. For instance, the Diabetes Prevention Program (DPP) study found that lifestyle modifications focusing on dietary changes and increased physical activity reduced the incidence of type 2 diabetes by 58% among high-risk individuals.Β 

Additionally, the Look AHEAD trial showed that intensive lifestyle interventions, including dietary counseling and exercise programs, led to significant weight loss and improvements in cardiovascular risk factors among adults with obesity and type 2 diabetes.

Medical and Pharmacological Interventions

Medications may play a crucial role in managing obesity, hypertension, and diabetes, but they should be used as part of a comprehensive treatment approach that includes lifestyle interventions and ongoing medical supervision.Β 

By addressing both pharmacological and non-pharmacological aspects of care, individuals can achieve better control of their conditions and reduce the risk of complications associated with obesity, hypertension, and diabetes.

Antidiabetic Medications

Oral antidiabetic medications, including metformin, sulfonylureas, and thiazolidinediones, are commonly prescribed to manage type 2 diabetes by improving insulin sensitivity, stimulating insulin secretion, or reducing glucose production in the liver.

Injectable medications like glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and insulin are used to control blood sugar levels in individuals with diabetes. GLP-1 RAs promote insulin secretion, suppress glucagon release, and slow gastric emptying, improving glycemic control and weight loss.

Antihypertensive Medications

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) block the effects of angiotensin II, a hormone that constricts blood vessels, potentially lowering blood pressure and reducing the risk of cardiovascular events.

Calcium channel blockers (CCBs) relax blood vessels and decrease the heart's workload, effectively lowering blood pressure.

Diuretics help the body eliminate excess sodium and water, reducing blood volume and blood pressure.

Weight Loss Medications

The FDA has approved five drugs for long-term treatment of overweight and obesity:

  • Phentermine-topiramate (Qsymia) suppresses appetite and promotes satiety, leading to weight loss.Β 
  • Orlistat (Xenical) works by inhibiting the absorption of dietary fats in the intestines, resulting in reduced calorie intake and weight loss.
  • Bupropion-naltrexone (Contrave) targets the brain's hunger and reward centers to decrease appetite and cravings while increasing feelings of fullness.
  • In addition to their role in managing diabetes, the GLP-1 RAs liraglutide (Saxenda) and semaglutide (Wegovy) have been approved for weight management in individuals with obesity.

The Role of Monitoring and Support

Regular health monitoring, including tracking blood sugar levels, blood pressure readings, weight, and fitness levels, allows individuals and healthcare providers to track progress, identify trends, and make informed decisions regarding treatment adjustments. By staying vigilant and proactive in monitoring their health, individuals can better manage their conditions and reduce the risk of complications. (19)Β 

Evidence suggests regular health monitoring, support, and patient education can significantly improve health outcomes. Research indicates that individuals who regularly monitor health parameters (e.g., blood pressure, weight, and fitness markers) are more likely to achieve their health goals. Moreover, interventions that incorporate support from healthcare providers, family, and support groups have been associated with improved medication adherence, lifestyle adherence, and overall health-related quality of life. (23, 25, 32, 44)Β 

Preventive Measures

Obesity, hypertension, and type 2 diabetes are largely preventable conditions that can be mitigated through modifiable risk factors. Individuals can significantly reduce their risk of developing cardiometabolic diseases by implementing healthy eating habits, engaging in regular physical activity, managing stress levels, maintaining a healthy weight, and avoiding tobacco use. These lifestyle factors promote a healthy metabolism, improve insulin sensitivity, and support optimal cardiovascular health.Β 

Scheduling routine health check-ups for early detection and intervention of cardiometabolic dysfunction is essential. By monitoring blood pressure, blood sugar levels, and weight, individuals can identify risk factors early and work with healthcare providers to implement preventive strategies before chronic disease sets in.Β 

[signup]

Key Takeaways

Breaking free from the cycle of obesity, diabetes, and hypertension is possible through informed lifestyle choices, medical intervention, and ongoing support. Individuals can take control of their cardiometabolic health by adopting healthy eating habits, engaging in regular physical activity, and working closely with healthcare providers to manage underlying conditions.

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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  1. American Heart Association Recommendations for Physical Activity in Adults and Kids. (2018, April 18). American Heart Association. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
  2. Anderson, S. (2022, May 19). 6 Preventable Risk Factors Associated With Heart Attacks. Rupa Health. https://www.rupahealth.com/post/5-things-to-do-after-a-heart-attack
  3. Angiotensin II Receptor Blockers (ARBs). (2022, June 17). Cleveland Clinic. https://my.clevelandclinic.org/health/drugs/23327-angiotensin-ii-receptor-blockers
  4. Arciero, P. J., Ives, S. J., Mohr, A. E., et al. (2022). Morning Exercise Reduces Abdominal Fat and Blood Pressure in Women; Evening Exercise Increases Muscular Performance in Women and Lowers Blood Pressure in Men. Frontiers in Physiology, 13. https://doi.org/10.3389/fphys.2022.893783
  5. Bertagna, B. (2024, January 9). The Science Behind Mindful Eating: How It Impacts Digestion and Overall Health. Rupa Health. https://www.rupahealth.com/post/the-science-behind-mindful-eating-how-it-impacts-digestion-and-overall-health
  6. Blake, K. (2023, April 28). What Is a Heart Healthy Diet and Who Should Follow One? Rupa Health. https://www.rupahealth.com/post/what-is-a-heart-healthy-diet-and-who-should-follow-one
  7. Calcium channel blockers. (2021, September 16). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/calcium-channel-blockers/art-20047605
  8. Cardiovascular Diseases. (2023). World Health Organization. https://www.who.int/health-topics/cardiovascular-diseases#tab=tab_1
  9. Christie, J. (2023, January 6). A functional medicine approach to obesity and weight management. Rupa Health. https://www.rupahealth.com/post/an-integrative-approach-to-obesity
  10. Cloyd, J. (2022, September 16). 9 Health Benefits of the DASH Diet. Www.rupahealth.com. https://www.rupahealth.com/post/9-health-benefits-of-the-dash-diet
  11. Cloyd, J. (2023, April 10). A Functional Medicine Hypertension Protocol. Rupa Health. https://www.rupahealth.com/post/functional-medicine-hypertension-protocol
  12. Cloyd, J. (2023, June 19). A Functional Medicine Post Stroke Protocol: Testing, Therapeutic Diet, and Integrative Therapy Options. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-post-stroke-protocol-testing-supplements-and-integrative-therapy-options
  13. Cloyd, J. (2023, July 3). The Role of Physical Activity in Promoting Heart Health. Rupa Health. https://www.rupahealth.com/post/the-role-of-physical-activity-and-exercise-in-promoting-heart-health-including-the-use-of-alternative-exercise-modalities-such-as-tai-chi-and-qigong
  14. Cloyd, J. (2024, February 26). Beyond Cardiovascular Health: Benefits of the Mediterranean Diet. Rupa Health. https://www.rupahealth.com/post/beyond-cardiovascular-health-benefits-of-the-mediterranean-diet
  15. Cloyd, K. (2023, December 7). Cardiovascular Disease and Metabolic Syndrome: Addressing Root Causes with Functional Medicine. Rupa Health. https://www.rupahealth.com/post/cardiovascular-disease-and-metabolic-syndrome-addressing-root-causes-with-functional-medicine
  16. Cloyd, K. (2023, December 19). How to interpret your lipid panel results. Rupa Health. https://www.rupahealth.com/post/how-to-interpret-your-lipid-panel-results
  17. Costello, R. A., & Shivkumar, A. (2020). Sulfonylureas. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513225/
  18. Creedon, K. (2022, July 14). Simple lifestyle changes that can help keep high blood pressure under control. Rupa Health. https://www.rupahealth.com/post/simple-lifestyle-changes-that-can-help-control-high-blood-pressure
  19. DeCesaris, L. (2024, January 19). The Psychology of Lab Results on Patient Adherence. Rupa Health. https://www.rupahealth.com/post/the-psychology-of-lab-results-on-patient-adherence
  20. Diabetes Prevention Program (DPP). (2019, March 8). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dpp
  21. Diuretics. (2021). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/diuretics/art-20048129
  22. Eggleton, J. S., & Jialal, I. (2020). Thiazolidinediones. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551656/
  23. Garg, R., Chawla, S. S., Kaur, S., et al. (2019). Impact of health education on knowledge, attitude, practices and glycemic control in type 2 diabetes mellitus. Journal of Family Medicine and Primary Care, 8(1), 261. https://doi.org/10.4103/jfmpc.jfmpc_228_18
  24. Ghadieh, A. S., & Saab, B. (2015). Evidence for exercise training in the management of hypertension in adults. Canadian Family Physician Medecin de Famille Canadien, 61(3), 233–239. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369613/
  25. Godman, H. (2021, July 1). Wearable fitness trackers may aid weight-loss efforts. Harvard Health. https://www.health.harvard.edu/staying-healthy/wearable-fitness-trackers-may-aid-weight-loss-efforts
  26. GΓ³mez-Pimienta, E., GonzΓ‘lez-Castro, T. B., Fresan, A., et al. (2019). Decreased Quality of Life in Individuals with Type 2 Diabetes Mellitus Is Associated with Emotional Distress. International Journal of Environmental Research and Public Health, 16(15). https://doi.org/10.3390/ijerph16152652
  27. Greenan, S. (2021, October 11). 7 Early Signs Of Insulin Resistance. Rupa Health. https://www.rupahealth.com/post/what-is-insulin-resistance
  28. Herman, L., & Bashir, K. (2022). Angiotensin Converting Enzyme Inhibitors (ACEI). Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK431051/
  29. High Blood Pressure–Understanding the Silent Killer. (2020, December 8). FDA. https://www.fda.gov/drugs/special-features/high-blood-pressure-understanding-silent-killer
  30. Khakham, C. (2023, March 28). An integrative medicine approach to kidney disease. Rupa Health. https://www.rupahealth.com/post/an-integrative-medicine-approach-to-kidney-disease
  31. Khakham, C. (2023, April 6). Understanding Your Risk of Cardiovascular Disease With Functional Medicine Labs. Rupa Health. https://www.rupahealth.com/post/understanding-your-risk-of-cardiovascular-disease-with-functional-medicine-labs
  32. Khoong, E. C., Commodore-Mensah, Y., Lyles, C. R., et al. (2022). Use of Self-Measured Blood Pressure Monitoring to Improve Hypertension Equity. Current Hypertension Reports, 24(11), 599–613. https://doi.org/10.1007/s11906-022-01218-0
  33. Lee, S. (2024, February 9). What Are GLP-1 Drugs, And Why Are They Becoming Popular? Rupa Health. https://www.rupahealth.com/post/what-are-glp-1-drugs-and-why-are-they-becoming-popular
  34. Maholy, N. (2023, March 9). Integrative Medicine Protocol For Reversing Type 2 Diabetes. Rupa Health. https://www.rupahealth.com/post/integrative-medicine-protocol-for-reversing-type-2-diabetes
  35. Metformin (Oral Route). Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/metformin-oral-route/side-effects/drg-20067074?p=1
  36. Mora, S., Cook, N., Buring, J. E., et al. (2007). Physical Activity and Reduced Risk of Cardiovascular Events. Circulation, 116(19), 2110–2118. https://doi.org/10.1161/circulationaha.107.729939
  37. Obesity. (2020, April 17). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/11209-weight-control-and-obesity
  38. Obesity. (2023, July 22). Mayo Clinic; Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742
  39. Paluch, A. E., Boyer, W. R., Franklin, B. A., et al. (2023). Resistance Exercise Training in Individuals With and Without Cardiovascular Disease: 2023 Update: A Scientific Statement From the American Heart Association. Circulation, 149(3). https://doi.org/10.1161/cir.0000000000001189
  40. Petrie, J. R., Guzik, T. J., & Touyz, R. M. (2018). Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. The Canadian Journal of Cardiology, 34(5), 575–584. https://doi.org/10.1016/j.cjca.2017.12.005
  41. Pi-Sunyer, X. (2014). The Look AHEAD Trial: A Review and Discussion of Its Outcomes. Current Nutrition Reports, 3(4), 387–391. https://doi.org/10.1007/s13668-014-0099-x
  42. Prescription Medications to Treat Overweight and Obesity. (2019, March). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/weight-management/prescription-medications-treat-overweight-obesity
  43. Prevent Diabetes Complications. (2022, November 3). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/managing/problems.html
  44. Rodbard, D. (2017). Continuous Glucose Monitoring: A Review of Recent Studies Demonstrating Improved Glycemic Outcomes. Diabetes Technology & Therapeutics, 19(S3), S-25-S-37. https://doi.org/10.1089/dia.2017.0035
  45. Shariq, O. A., & McKenzie, T. J. (2020). Obesity-related hypertension: a review of pathophysiology, management, and the role of metabolic surgery. Gland Surgery, 9(1), 80–93. https://doi.org/10.21037/gs.2019.12.03
  46. Stanford, J. (2024, January 19). Functional Medicine Interventions for Obesity in Diabetic Patients: A Comprehensive Approach. Rupa Health. https://www.rupahealth.com/post/functional-medicine-interventions-for-obesity-in-diabetic-patients-a-comprehensive-approach
  47. Stanford, J. (2024, March 19). Exploring the Link Between Insulin Resistance and Obesity. Rupa Health. https://www.rupahealth.com/post/insulin-resistance-obesity
  48. Type 2 diabetes diagnosis at age 30 can reduce life expectancy by up to 14 years. (2023, October 3). University of Cambridge. https://www.cam.ac.uk/research/news/type-2-diabetes-diagnosis-at-age-30-can-reduce-life-expectancy-by-up-to-14-years
  49. Yoshimura, H. (2023, November 13). Guarding Your Health: Proactive Steps to Ward Off Insulin Resistance. Rupa Health. https://www.rupahealth.com/post/guarding-your-health-proactive-steps-to-ward-off-insulin-resistance
  50. Yoshimura, H. (2023, November 13). Sweat It Out: The Powerful Connection Between Exercise and Insulin Sensitivity. Rupa Health. https://www.rupahealth.com/post/sweat-it-out-the-powerful-connection-between-exercise-and-insulin-sensitivity
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Hey Practitioners! On December 11th, join Dr. Terry Wahls in a free live class where she'll share her groundbreaking methods for managing MS and autoimmune patients. This live session will address your most pressing questions and will take a closer look at treatment options beyond the conventional standards of care. Register here.

Register Here