High BMI Remains Potential Diabetes Trigger

Metabolic health, lack of other risk factors offer no added protection….

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The cohort study consisted of 33.939 men, 30.9 +/- 5.2 years of age in military service period for a routine health examination and screening test at the Staff Periodic Examination Center. BMI was used to define obesity (>30kg/m2), overweight (30>BMI>25kg/m2) and normal weight (<25kg/m²) in the presence of normal blood pressure, glycemia, and cholesterol levels.

The result was 734 new cases of diabetes that were diagnosed among 210,282 participants after years of follow up. The incidence rate of diabetes with no metabolic risk factors was 1.15 for normal, 2.10 for overweight and 4.34 cases for obese per 1,000 person-years. The study model was adjusted for age, region of origin, family history of diabetes, physical activity, fasting plasma glucose, triglyceride level, HDL cholesterol, systolic blood pressure, and white blood cell count. Higher diabetes risk was observed among overweight group (HR 1.89; 95% CI 1.25-2.86; P<0.001), and obese group (HR 3.88; 95% CI 1.94-7.77; P<0.001) compared with normal weight group.

The researchers concluded that overweight and obesity can still lead to diabetes even with a normal metabolic panel. This shows the importance of a strict follow up of overweight and obese young men for diabetes incidence, independent of the presence of other metabolic risk factors.

Practice Pearls:

• Young men with an abnormal BMI (>25kg/m2) are associated with increased risk for diabetes.
• Healthy young adults with no metabolic risk factors are not protected against the incidence of diabetes associated with overweight and obesity.
• Tight follow up for overweight and obesity patients for the incident of diabetes.

Diabetes risk among overweight and obese metabolically healthy young adults. American Diabetes Association. August 19, 2014. https://care.diabetesjournals.org/content/37/11/2989.full