Obesity, Diabetes mellitus and Methylenetetrahydrofolate reductase mutations: Deadly combinations? How to approach them?

Obesity and diabetes mellitus (DM) are important independent risk factors for the development of cardiovascular disease (CVD). Obesity is the leading risk factor for type 2 diabetes. The Centers for Disease Control and Prevention report that 32% of white and 53% of black women are obese. Women with a body mass index (BMI) of 30 kg/m2 have a 28 times greater risk of developing diabetes than do women of normal weight. The risk of diabetes is 93 times greater if the BMI is 35 kg/m2 . The presence of DM can increase a woman's risk of heart disease 2-fold. In addition, the presence of diabetes overshadows the protective effects of the premenopausal state [1]. Obesity is common, serious, and costly. The prevalence of obesity was 39.8% and affected about 93.3 million of US adults in 2015-2016 [2]. The estimated annual medical cost of obesity in the United States was $147 billion in 2008 US dollars; the medical cost for people who have obesity was $1,429 higher than those of normal weight [3]. Regarding diabetes mellitus (DM), it's a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. In 2014, 8.5% of adults aged 18 years and older had diabetes. In 2016, diabetes was the direct cause of 1.6 million deaths and in 2012 high blood glucose was the cause of another 2.2 million deaths [4].