Mortality Risk Higher Across All BMIs With Diabetes
Patients with new-onset type 2 diabetes with a body mass index (BMI) of 40 kg/m2 or more have significantly increased mortality risk compared with controls and those with a BMI of 25 to <30 kg/m2, according to a recent study.
For their study, the researchers assessed data on short- and long-term mortality in 149,345 patients with type 2 diabetes (mean age: 59.6 years) and 743,901 age- and sex-matched controls. Median follow-up lasted 5.5 years. Data were obtained from the Swedish National Diabetes Registry between 1998 and 2012.
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A total of 17,546 patients with type 2 diabetes and 68,429 controls died over the course of follow-up. Following adjustment, short-term all-cause mortality risk within 5 years or less had demonstrated a U-shaped relationship with BMI. Hazard ratios (HRs) ranged from 0.81 in patients with diabetes and a BMI of 30 to <35 kg/m2 to 1.37 in those with a BMI of at least 40 kg/m2 compared with controls.
Findings ultimately indicated that patients in all weight categories had an increased mortality risk, with a nadir at BMI 25 to <30 kg/m2 and a stepwise increase in patients with a BMI of at least 40 kg/m2 (HR 2.00). The researchers noted that this risk was more evident in patients younger than age 65 years.
“Our findings suggest that the apparent paradoxical findings in other studies in this area may have been affected by reverse causality,” the researchers concluded. “Long-term, overweight (BMI 25 to <30 kg/m2) patients with type 2 diabetes had low excess mortality risk compared with control subjects, whereas risk in those with BMI ≥40 kg/m2 was substantially increased.”
—Christina Vogt
Reference:
Edqvist J, Rawshani A, Adiels M, et al. BMI and mortality in patients with new-onset type 2 diabetes: a comparison with age- and sex-matched control subjects from the general population. Diabetes Care. 2018;41(1). https://doi.org/10.2337/dc17-1309.