Is Weight Loss For Every Diabetes Patient?

Type 2 diabetes patients who are obese or of normal weight had higher risk of death than overweight patients

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) If you have type 2 diabetes, your weight can have a huge impact on your risk of complications and death. One might think the heavier you are, the higher your risk. However, the scenario may not be as simple as that.

A recent study found that patients with type 2 diabetes who were of normal weight or obese had a higher risk of death within one year of diagnosis compared to overweight patients.

This finding suggests that losing weight may not be equally important for all patients with type 2 diabetes.

"Ask your diabetes specialist how to best control your weight."

Many studies have shown a link between body mass index (BMI) - a measure of body fat using height and weight - and the risk of complications related to diabetes. These studies often suggested that higher BMIs were associated with higher risks.

A study by Jennifer Logue, MD, of the University of Glasgow in the UK, and colleagues found that the picture may be a little more complex when it comes to the risk of death.

As might be expected, obese diabetes patients (BMI of 35 or more) had a higher risk of death than overweight patients (BMI of 25 to 30). Interestingly, however, normal weight patients (BMI of 20 to 25) also had a higher risk of death than overweight patients.

Men and women within each BMI group had different risks of death compared to overweight patients, with women consistently having a higher risk.

Weight loss programs are a major part of diabetes management for many patients. The findings of this study call into question whether weight loss programs lower the risk of death in all patients with type 2 diabetes.

For their study, Dr. Logue and colleagues used hazard ratios to explain the risk of death among diabetes patients of different BMI groups. A hazard ratio explains how much an event happens in one group versus another. A hazard ratio of more than 1.0 means that event - in this case, death - happens more often in the first group than in the second.

Results showed that compared to overweight patients, the hazard ratio for death was:

  • 1.22 among men of normal weight
  • 1.32 among women of normal weight
  • 1.70 among severely obese men (BMI of 45 to 50)
  • 1.81 among severely obese women

The researchers also found that the risk of vascular death, or death related to blood vessel problems, increased by 24 percent in men and 23 percent in women for every 5 point increase in BMI over 30. In simpler terms, the more obese patients became, the higher their risk of vascular death.

The research included 106,640 patients whose BMI was recorded around the time of diagnosis with diabetes.

The study was published November 8 in Diabetes Care, a journal of the American Diabetes Association. 

Reviewed by: 
Review Date: 
November 12, 2012
Last Updated:
November 15, 2012