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Query: UMLS:C0037315 (sleep apnea)
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In the last 20 years, there has been a dramatic upsurge in the average weight of Australian adults. In this period, on average, Australian women have gained 4.8 kg, whilst Australian men have gained 3.6 kg. Consequently, the prevalence of obesity in men has increased from 8% to 19% and in women from 7% to 21%. This threatens to wipe away many recent health gains, as obesity has been associated with a wide range of chronic and debilitating illnesses, such as diabetes, heart disease, some cancers, sleep apnoea and osteoarthritis. Any weight gain in adulthood is usually as a result of an increase in fat stores, and the risk of ill-health from increasing weight actually begins at quite low BMI. Unfortunately, weight gain can be difficult or slow to reverse in the middle years because of physiological and behavioural changes that occur at this time of life. Adults should focus on preventing or minimizing weight gain over time by retaining physical activity within their daily living and by sensible dietary changes. Even if weight gain does occur with age, a regimen of regular exercise and a diet rich in fruit and vegetables and low in fat will provide some protection against a rapid decline in health.
Asia Pac J Clin Nutr 2002
PMID:Importance of preventing weight gain in adulthood. 1249 56

Allergic rhinitis (AR) is the most common chronic pediatric disorder. The International Study for Asthma and Allergies in Childhood phase III found that the global average of current rhinoconjunctivitis symptoms in the 13-14 year age-group was 14.6% and the average prevalence of rhinoconjunctivitis symptoms in the 6-7 year age-group was 8.5%. In addition to classical symptoms, AR is associated with a multidimensional impact on the health related quality of life in children. AR affects the quality of sleep in children and frequently leads to day-time fatigue as well as sleepiness. It is also thought to be a risk factor for sleep disordered breathing. AR results in increased school absenteeism and distraction during class hours. These children are often embarrassed in school and have decreased social interaction which significantly hampers the process of learning and school performance. All these aspects upset the family too. Multiple co-morbidities like sinusitis, asthma, conjunctivitis, eczema, eustachian tube dysfunction and otitis media are generally associated with AR. These mostly remain undiagnosed and untreated adding to the morbidity. To compound the problems, medications have bothersome side effects which cause the children to resist therapy. Children customarily do not complain while parents and health care professionals, more often than not, fail to accord the attention that this not so trivial disease deserves. AR, especially in developing countries, continues to remain a neglected disorder.
Asia Pac Allergy 2012 Apr
PMID:Impact of allergic rhinitis in school going children. 2270 58

Diabetes risk increases exponentially with increasing BMI particularly if fat accumulates centrally and/or in the skeletal muscle, liver and other organs such as the pancreas. Those with diabetes and co-existing obesity, particularly if it is severe, are also at risk of other obesity-related conditions, such as cardiovascular disease, obstructive sleep apnoea, joint pain, many cancers and depression. In people with impaired glucose tolerance, modest weight loss can reduce the development of overt diabetes by 50% or more over four years. Once diabetes has developed weight loss can also be of benefit. Supporting patients to lose weight should be considered a key goal of diabetes care for all overweight and obese patients with type 2 diabetes. Increased physical activity improves insulin sensitivity and can help weight loss maintenance. Metformin is the first-line therapy and is generally considered weight neutral. Of the oral therapies available second line, DPP-IV inhibitors are weight neutral and the newer SGLT2 inhibitors can produce 2-3 kg of weight loss on average. Insulin often causes weight gain and patients should be counselled about this. Adjunctive treatment with metformin, SGLT2 inhibitors, DPP-IV inhibitors and GLP-1 analogues can help keep insulin doses lower and limit weight gain. Currently in the UK, obesity pharmacotherapy in type 2 diabetes is limited to orlistat which has been shown to improve glucose control. NICE recommends bariatric surgery as a clinically and cost effective option for obese patients with type 2 diabetes, particularly those with severe obesity. It typically results in 20-30% of body weight loss.
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PMID:Managing patients with type 2 diabetes and obesity. 2572 18

Most studies of disease etiologies focus on one disease only and not the full spectrum of multimorbidities that many patients have. Some disease pairs have shared causal origins, others represent common follow-on diseases, while yet other co-occurring diseases may manifest themselves in random order of appearance. We discuss these different types of disease co-occurrences, and use the two diseases "sleep apnea" and "diabetes" to showcase the approach which otherwise can be applied to any disease pair. We benefit from seven million electronic medical records covering the entire population of Denmark for more than 20 years. Sleep apnea is the most common sleep-related breathing disorder and it has previously been shown to be bidirectionally linked to diabetes, meaning that each disease increases the risk of acquiring the other. We confirm that there is no significant temporal relationship, as approximately half of patients with both diseases are diagnosed with diabetes first. However, we also show that patients diagnosed with diabetes before sleep apnea have a higher disease burden compared to patients diagnosed with sleep apnea before diabetes. The study clearly demonstrates that it is not only the diagnoses in the patient's disease history that are important, but also the specific order in which these diagnosis are given that matters in terms of outcome. We suggest that this should be considered for patient stratification.
Pac Symp Biocomput 2017
PMID:TEMPORAL ORDER OF DISEASE PAIRS AFFECTS SUBSEQUENT DISEASE TRAJECTORIES: THE CASE OF DIABETES AND SLEEP APNEA. 2789 91