Féaron C. Cassidy

By Féaron C. Cassidy, Sinead Lafferty and Cynthia M. Coleman

Almost half a billion people worldwide are living with diabetes mellitus (DM). Complications associated with DM are common and approximately half of those people with DM suffer from at least one comorbidity. There is high mortality, morbidity and cost associated with these comorbidities which include cardiovascular disease, retinopathy, nephropathy, neuropathy and osteopathy. Gender influences the relative risk of developing complications from DM via differing mechanisms – both directly and indirectly. Generally, an increased relative risk of cardiovascular disease and kidney disease is noticed in women with DM compared to the non-DM context, where rates of both are much higher in men. Men appear to be at greater risk of diabetic retinopathy and also of insensate diabetic neuropathy, whereas women suffer from an increased rate of painful diabetic neuropathy compared to men. These differences are not clear cut and vary regionally and temporally, indicating that the field would benefit from further research on both the epidemiology and physiological mechanism of the observed patterns. These differences should be taken into account in treatment programmes for DM and its comorbidities.

Part of the book: Type 2 Diabetes

By Andrea Woodcock and Féaron C. Cassidy

Obesity is associated with an increased risk of a wide range of morbidities. A major mechanism for this increased risk is dysfunction of the immune system. Immune dysfunction associated with obesity resulting is associated with an increased risk of a number of both communicable and non-communicable diseases. Non-communicable diseases such as type 2 diabetes mellitus (T2DM) make up the majority share of the research and discourse in relation to obesity. However, some infections are found to result in increased disease severity and higher risk of mortality in people with obesity. This was an evident and concerning trend during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Additionally, some vaccines have been found to induce as little as half the protection from disease in people with obesity compared to people without obesity. In this chapter we discuss the impact of obesity during infection and its impact on vaccination—two key considerations that together contribute to the vulnerability of people with obesity, and to public health more generally. We discuss the mechanisms in relation to the dysregulation of immune cells in obesity. Understanding these dysfunctions is crucial and timely as the rates of obesity continue to increase worldwide. Over a billion people worldwide are now living with obesity, resulting in increased individual and population-level disease risk.

Part of the book: Adipose Tissue Homeostasis in Health and Disease

By Féaron C. Cassidy

Part of the book: Adipose Tissue Homeostasis in Health and Disease