Thin Diabetics may be more in danger than obese ones

Thin Diabetics may be more in danger than obese ones

Type 2 diabetes, a condition thought of as a disease of the over- weight and sedentary, also develops in people who aren’t overweight. And it may be deadlier in these normal – weight people, a new study shows.

In the study reported in The Journal of the American Medical Association, researchers revived data of more than 2500 people with Type 2 diabetes over decades.

They found that those of normal weight at the time of their diagnoses were twice as likely to die during the study period, compared with those who were overweight or obese.

The researchers could not explain why having a greater BMI (body mass index), might protect someone with diabetes. But they pointed out that doctors may be prone to treating thin diabetics differently from their obese counter parts, and may be less likely to push them to make diet and exercise changes to improve their survival.

“Normal –weight people may be treated less aggressively,” said Mercedes R.Carnethon, the study’s author and professor of preventive medicine at North western University Feinberg School of Medicine. “This is an argument to treat a normal –weight person with diabetes as aggressively as you would treat overweight persons with diabetes.”

The findings also provide evidence that patients with Type 2 diabetes may display what researchers call the obesity paradox, the observation that people certain chronic disease tend to have lower mortality rates if they carry excess pounds. The phenomenon has been documented previously in people with heart failure, hypertension and kidney disease.

“We thought perhaps that the obesity paradox wouldn’t apply to this population, given  the strong association between overweight and diabetes,” Dr Carnethon said.

Carrying excess weight is clearly linked to Type 2 diabetes. Being obese not only makes the disease more likely, but is also linked with worse control of blood sugar levels, blood pressure and cholesterol. But minority of Type 2 diabetics (15 % 20) are neither overweight nor obese, phenomenon researchers do not fully understand.

Earlier studies of the obesity paradox may have been flawed because they classified as “normal weight” people in the late stages of disease, Dr Carnethon said. To ensure normal –weight diabetics in the study were not in the later stages of disease, researchers pinpointed the subjects’ weight as close to the time of diagnosis as possible. The authors also did not want to confuse normal – weight subjects with people who had been overweight or obese but then lost the weight after a diagnosis of diabetes. They found that people who had a normal BMI at the time diabetes was diagnosed were twice as likely to die during the study period, compared with heavier peers.

Dr Carnethon noted the findings were particularly important for Americans most at risk for normal weight diabetes, including blacks, people of Asian heritage and older adults. She said there may be a hereditary component to the phenomenon that causes some diabetics to be “genetically loaded,” with genetic variants that predispose them to diabetes and other illness. “It’s probable that these normal weight adults with diabetes have more abdominal adiposity,” or fat in the midsection. “That particular fat distribution is dangerous for metabolic disorders.”

An editorial on the findings should be viewed as a “wake-up call for timely prevention and management to reduce adverse outcomes in all patients with Type 2 diabetes.” the advice is relevant to normal – weight diabetics, “who may have a false sense of protection because they are not overweight or obese ,” said the editorial.

Thank You,

TIMES OF INDIA 12-AUGUST-2012