Mortality Risk Increases with Diabetes, BMI
Body mass index (BMI) and worsening diabetes status were associated with an increased mortality risk, according to the findings of a recent study.
In their study, the researchers prospectively monitored 12,815,006 adults. Individuals were categorized by their diabetes status, which was defined as normoglycemia (fasting glucose less than 100 mg/dK), impaired fasting glucose (100 to 125 mg/dL), newly diagnosed diabetes (126 or greater mg/dL), and prevalent diabetes (self-reported). In addition, BMI was measured.
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Over the mean 10.5 years of follow-up, 454,546 men and 239,877 women died.
The researchers found U-shaped associations between BMI and mortality, which was observed regardless of diabetes status, sex, age, and smoking history. The optimal BMI associated with lower mortality was 23.5-27.9 kg/m2 for normoglycemia, 25-27.9 kg/m2 for impaired fasting glucose, 25 to 29.4 for newly diagnosed diabetes, and 26.5 to 29.3 for prevalent diabetes.
Higher optimal BMI by worsening diabetes status was more prominent for younger ages, especially for women. Additionally, the association between worsening diabetes status and higher mortality risk was strongest with lower BMI, especially at younger ages.
Individuals with prevalent diabetes had a higher mortality risk compared with those newly diagnosed with diabetes at the same BMI. This association was more prominent in women than with men.
“U-curve relationships existed regardless of diabetes status,” the researchers concluded. “Optimal BMI for lowest mortality became gradually higher with worsening diabetes for each sex and each age-group.”
—Melissa Weiss
Reference:
Lee EY, Lee YH, Yi SW, Shin SA, Yi JJ. BMI and all-cause mortality in normoglycemia, impaired fasting glucose, newly diagnosed diabetes, and prevalent diabetes: a cohort study [published online July 21, 2017. Diabetes Care. doi:10.2337/dc16-1458.